How To Use This Order Form
Place a checkmark in the box of the product you wish to purchase. Select quantity using the drop down menu tab directly below the box you've check.
Scroll down toward the bottom of the page and fill out your personal information. Click the place order button to send us the order.
Nordic Naturals
ProDHA
Supports Memory, Learning, and Mood
Natural Triglyceride Form
Pharmaceutical Grade, Molecularly Distilled
90 Soft Gels
Item Number: NNPRODHA Cost: $28.95
Check box to order. Select Here 1 Bottle 2 Bottles 3 Bottles 4 Bottles 5 Bottles Quantity
Douglas Laboratories
Citrus-Q10
Natural Coenzyme Q10
Can improve physical and mental processes
60 Tablets
Item Number: DLCOQ10 Cost: $49.80
Healthway Pharmacy Wellness Center
Quercetin Plus
Tends to ease allergy symptoms that may
aggravate ADD and ADHD.
With Vitamin C & Turmeric
500 mg
50 Tablets
Item Number: HWCQUERCETIN Cost: $19.29
Vitamin C 1000 mg
Helps combat stress.
With Bioflavonoid Complex
100 Capsules
Item Number: HWCVITC Cost: $15.87
Ordering Instructions
*Mandatory Fields *As it appears on your credit card statement
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Customer Credit Card Information
*First Name: **Last Name: **Address: **City: **State: **Zip/Postal Code: **Phone: (Day) (Evening) *Email:
Credit Card Information
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Customer Shipping Information
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If you have ordered from us previously: Customer Number:
Comments or Additional Information
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Healthway Pharmacy 1008 N. Saginaw St.St. Charles, Michigan 48655
989-865-9971 - Phone989-865-6216 - Fax 1-800-742-7527 - Toll Free
Healthway Compounding Pharmacy 2544 McLeod Dr., N.Saginaw, Michigan 48604
989-791-1691 - Phone989-791-4603 - Fax1-866-883-8868 - Toll Free