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1300 564 799

We create tailored compounded medicine and deliver within Australia and Internationally.

PRESCRIPTION ORDER FORM FOR DR. E VARIPATIS

Please fill out the form below for our team to start the process of fulfilling the required prescription.

Prescription Date

DD slash MM slash YYYY

Patient Name(Required)

First Last

Date of Birth

DD slash MM slash YYYY

Patient Preferred Phone Number

Email

Preferred delivery Method

To be arranged

Pickup at Kingsway Compounding

Pickup at Dee Why Pharmacy on Kingsway

Courier or Express Post

Delivery Address (if Courier or Express Post)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Product Selection

Bioclinic Naturals

Bioclinic Naturals AllergEase (90 caps)

Bioclinic Naturals DetoxClear (378g)

Bioclinic Naturals ElementALL Diet (750gm)

Bioclinic Naturals IBS Relief (90 caps)

Bioclinic Naturals Immunoguard (90 caps)

Bioclinic Naturals Oestrosense (90)

Bioclinic Naturals Oregano Oil (60 softgels)

Bioclinic Naturals Opti D3 & K2 (90 softgels)

Bioclinic Naturals SIBO balance (60 softgels)

AllergEase (90 caps) Instruction

DetoxClear (378g) Instruction

ElementALL Diet (750gm) Instruction

IBS Relief (90 caps) Instruction

Immunoguard (90 caps) Instruction

Oestrosense (90) Instruction

Oregano Oil (60 softgels) Instruction

Opti D3 & K2 (90 softgels) Instruction

SIBO balance (60 softgels) Instruction

BioMedica

BioMedica Bio-Activated B (60)

BioMedica BioTress (150)

BioMedica C-Max (200g)

BioMedica Histease (60)

BioMedica LaxPro Restore (225g)

BioMedica Natal Care (150)

BioMedica Neuro S (60)

BioMedica Oxyguard (60)

BioMedica PeptEase (60 chewable)

BioMedica Ribraxx (30 sachets)

Bio-Activated B (60) Instruction

BioTress (150) Instruction

C-Max (200g) Instruction

Histease (60) Instruction

LaxPro Restore (225g) Instruction

Natal Care (150) Instruction

Neuro S (60) Instruction

Oxyguard (60) Instruction

PeptEase (60 chewable) Instruction

Ribraxx (30 sachets) Instruction

Bio-Practica

Bio-Practica Adrenergy Forte (60 tabs)

Bio-Practica GenoMulti Active B (45 tabs)

Bio-Practica ImmunePro Plus (60 tabs)

Bio-Practica Matrix Phase Detox (200g)

Bio-Practica RejuvaSleep Forte N (30 tabs)

Adrenergy Forte (60 tabs) Instruction

GenoMulti Active B (45 tabs) Instruction

ImmunePro Plus (60 tabs) Instruction

Matrix Phase Detox (200g) Instruction

RejuvaSleep Forte N (30 tabs) Instruction

Designs For Health (DFH)

DFH Collagen – Active Muscle Collagen (450g)

DFH Complete Joint Collagen (450g)

DFH Whole Body Collagen (375g)

DFH Berb-Evail (60 caps)

DHF C Plus Supreme (150g)

DFH Curcum-Evail (60 caps)

DFH Ferro-Supreme (60 caps)

DFH FloraMyces (60 caps)

DFH Gastro-Mend – HP (60 caps)

DFH GI Microb-X (60 caps)

DFH GI-Revive (225g)

DFH Immunitone Plus (90 caps)

DFH Immuno-Zn lozenge (90 chewable tabs)

DFH Liposomal GSH (50ml)

DFH Liposomal Methyl B12 (50ml)

DFH Liposomal Vitamin D3 (50ml)

DFH OmegaAvail TG 1000 (120 caps)

DFH Probiomed 50 (60 caps)

DFH NR Supreme (30 caps)

DFH Paleo Fibre (300g)

DFH PEA Levagen (60 caps)

DFH Prenatal Pro (90 caps)

DFH Triganda (60 caps)

DFH Tri-Mag Active Muscle (300g)

DFH Twice Daily Multi (60 caps)

DFH Ubiq-Evail (60 caps)

DFH Zymegest (60 caps)

DFH Collagen – Active Muscle Collagen (450g) Instruction

DFH Complete Joint Collagen (450g) Instruction

DFH Whole Body Collagen (375g) Instruction

DFH Berb-Evail (60 caps) Instruction

DHF C Plus Supreme (150g) Instruction

DFH Curcum-Evail (60 caps) Instruction

DFH Ferro-Supreme (60 caps) Instruction

DFH FloraMyces (60 caps) Instruction

DFH Gastro-Mend – HP (60 caps) Instruction

DFH GI Microb-X (60 caps) Instruction

DFH GI-Revive (225g) Instruction

DFH Immunitone Plus (90 caps) Instruction

DFH Immuno-Zn lozenge (90 chewable tabs) Instruction

DFH Liposomal GSH (50ml) Instruction

DFH Liposomal Methyl B12 (50ml) Instruction

DFH Liposomal Vitamin D3 (50ml) Instruction

DFH OmegaAvail TG 1000 (120 caps) Instruction

DFH Probiomed 50 (60 caps) Instruction

DFH NR Supreme (30 caps) Instruction

DFH Paleo Fibre (300g) Instruction

DFH PEA Levagen (60 caps) Instruction

DFH Prenatal Pro (90 caps) Instruction

DFH Triganda (60 caps) Instruction

DFH Tri-Mag Active Muscle (300g) Instruction

DFH Twice Daily Multi (60 caps) Instruction

DFH Ubiq-Evail (60 caps) Instruction

DFH Zymegest (60 caps) Instruction

Eagle

Eagle Tresos Activated B PluSe (150 caps)

Eagle Potasi (60 tabs)

Tresos Activated B PluSe (150 caps) Instruction

Potasi (60 tabs) Instruction

Fulvic Acid Australia

Fulvic Acid Australia “Natural Edge” Fulvic Acid (200ml)

“Natural Edge” Fulvic Acid (200ml) Instruction

MediHerb

MediHerb Rhodiola & Schisandra (60tabs)

Rhodiola & Schisandra (60tabs) Instruction

Medlab

Medlab NanoCelle Activated B12 (30ml)

Medlab NanoCelle D3 (30ml)

NanoCelle Activated B12 (30ml) Instruction

NanoCelle D3 (30ml) Instruction

Metagenics

Metagenics Lipoplex (120gm)

Metagenics NeuroCalm Sleep (60 tabs)

Metagenics Ultraflora Intensive Care (60 caps)

Metagenics Ultraflora LGG forte (60 caps)

Metagenics Ultraflora Restore (DF) (60 caps)

Lipoplex (120gm) Instruction

NeuroCalm Sleep (60 tabs) Instruction

Ultraflora Intensive Care (60 caps) Instruction

Ultraflora LGG forte (60 caps) Instruction

Ultraflora Restore (DF) (60 caps) Instruction

RN Labs

RN labs Estroforte (60 caps)

RN labs GI Defence (210g)

RN labs Micro Clear (60 caps)

RN labs Progest Fortify (60 caps)

RN Labs Enterosgel (225g tube)

RN Labs ‘Inflamasoothe Trio’ (60 caps)

RN Labs ‘Micronised PEA 300mg' (120 caps)

RN labs Estroforte (60 caps) Instruction

RN labs GI Defence (210g) Instruction

RN labs Micro Clear (60 caps) Instruction

RN labs Progest Fortify (60 caps) Instruction

Enterosgel (225g tube) Instruction

RN Labs ‘Inflamasoothe Trio’ (60 caps)

RN Labs ‘Micronised PEA 300mg' (120 caps)

Spectrumceuticals

(SC) Bifido Complex (60 caps)

(SC) Pro4-50 D-Lactate Free (60 caps)

(SC) Pro4-50 D-Lactate Free (60g powder)

(SC) Pro6-Infant (60g)

(SC) Pro8-Forte (60 caps)

(SC) Bio-One SB 500 (90 caps)

(SC) Bio-One L. Rhamnosus GG 20b (60 caps)

(SC) Primer Plus (90 caps)

(SC) ParaTri (50ml)

(SC) Microbiome Prebiotic (100g)

(SC) Bifido Complex (60 caps) Instruction

(SC) Pro4-50 D-Lactate Free (60 caps) Instruction

SC) Pro4-50 D-Lactate Free (60g powder) Instruction

(SC) Pro6-Infant (60g) Instruction

SC) Pro8-Forte (60 caps) Instruction

(SC) Bio-One SB 500 (90 caps) Instruction

(SC) Bio-One L. Rhamnosus GG 20b (60 caps) Instruction

(SC) Primer Plus (90 caps) Instruction

(SC) ParaTri (50ml) Instruction

(SC) Microbiome Prebiotic (100g) Instruction

Amino-Ther Pro

Amino-Ther Pro (30 sachets)

Amino-Ther Pro (30 sachets) Instruction

Coconut Magic

C8 MCT Oil (480ml)

(CM) C8 MCT Oil (480ml) Instruction

InnovAAte

OptimAAte powder (200g)

ElectrAAte powder (200g)

(INO) OptimAAte powder (200g) Instruction

(INO) ElectrAAte powder (200g) Instruction

Other products required

Please place in the details for any other compounded medicine that is required for the patient.

Special Instructions

Signature

Script Expiry

Email

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Our Difference

Kingsway vs Traditional
Why Choose Kingsway

Our Practitioners

Patient Conditions
Prescription Order Form

People We Help

Adults
Families & Fertility
Infants (Paediatrics)
Seniors
Toddlers & Young Children

About

Community & Resources
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Kingsway Compounding

40/9 Powells Road
Brookvale NSW 2100
Australia

Ph: 1300 564 799
Fax: 1300 564 899

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