This service is for Established Patients ONLY.
Millennium-TBI Protocol Supplements
BRAIN CARE II. 150cc	Purchase. None One (1) $75.00 Two (2) $99.00
Clear Mind & Energy	Purchase None One (1) $39.95 Three (3) $105.00 Six (6) $200.00 Twelve (12) $380.00
Secretropin 20cc	Purchase. None One bottle $100.00 Three bottles $250.00
1. UltraNutrient: # 360	Purchase None One bottle $130.00 Two bottles $260.00
2. Pregnenolone 100mg #100	Purchase None One bottle $35.00 Two bottles $70.00
3. DHEA 25mg #180 ($40)	Purchase None One (1) Two (2)
4. Ultra B w/PQQ #60 :($70)	Purchase None One (1) Two (2)`
5. Cognitive Aminos #120:($40)	Purchase Phasing out. One (1) Two (2)
6. Vitamin D 10K #120:($40)	Purchase None One (1) Two (2)
7. Vitamin D 5K #120:($35)	Purchase None One (1) Two (2)
8. N-Acetyl Cysteine 900mg #240 ($75)	Purchase Phasing Out for Brain Care2 One (1) Two (2)
9. Quercetin 500mg #120:($38)	Purchase Phasing Out for Brain Care2 One (1) Two (2)
10. ChromeMate 30mg #180 ($40)	Purchase None One (1) Two (2)
11. Zinc Citrate 15mg  #120 ($20)	Purchase None One (1) Two (2) Three (3)
12. Chlomiphene 50mg #30:($)	Purchase Rx needed. None One (1) Two (2)
13. Thyroid 32.5mg, #100:($60)	Purchase Rx needed. None One (1) Two (2)
14. Thyroid 48.5mg, #100:($60)	Purchase requires Rx. None One (1) Two (2)
15. Thyroid 65mg, #100:($60)	Purchase requires Rx. None One (1) Two (2)
16. Core4 Program:($275)	Purchase. None One (1)
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Credit Card Information
I am a returning Client:	Please use my card on file Do not use my card on File Please use this NEW card Dr. Alison Gordons Patient
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Please check off the box authorizing our office to package your requested supplements and to charge your credit card. We will not call you, but you will receive a copy of the credit card transaction immediately after it is APPROVED. All card documentation is destroyed after use. By checking this box I authorize the charges to my credit card which I have authorized to be on File. I approve of these charges
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