Clean As a Whistle Allergy Support (PeeKay)

Apply Custom Rx Label ?

* Fill Out the Information Below for Custom Labelling

Reference Name*:

(For your records)

Formula Label Name:

(To be printed on label)

Pharmacy Instructions:

Kamwo Suggestions:

dosing instructions

Manufacturer Label Unit Size:

Manufacturer Label Dosages:

Take 5 to 10 squirts, 2-3 times per day, or as directed by your health care provider.

Manufacture spoonful (1.0g)

Capsule (0.7g)

Times Daily:

Number of Days:

---- OR ---- Click checkbox to add Instructions.

Custom Instructions:

(60 charecters max)

Refills:

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* Creating and Using Custom Labels what does create and use custom label mean?

Kamwo replaces the Manufacture's label with a Rx label with custom info entered by practitioner.

why should I create a custom label?

Manage patient dosing by specifying number of refills.

Prevent patient from self-medicating (without practitioner consultation) by buying medicine with manufacture label.

Add retainer (for practitioner effort) with a total price that is above product's retail price.

PATIENT NAME: The name of the patient whom this product is intended to be used by.

Formula Label Name: Name of the formula used in the prescription.

Unit Size: Size of the prescription, based on grams and the number of bottles.

Custom Practitioner Dosing Instructions: Choose from preloaded instructions or create your own set.

Date Filled: The date that the prescription was filled for the patient.

Expiration Date: The date that the product is best used by.

Rx Number: Number allocated with the prescription.

Practitioner Name: The patient's prescribing Practitioner's full name.

Description:

Patent Formula Name

Alternative Name

Product Line

PeeKays by Paul Kempisty, L.Ac

Dosage Forms

Tincture

Unit Size

Dosage

Take 5 to 10 squirts, 2-3 times per day, or as directed by your health care provider.

Allergy Warning

Ingredients

Nettles Leaf - Urtica Dioica

rnTurmeric Rhizome - Curcuma Longa

rnForsythia Flower - Lian Qiao

rnHoutuymia Herb - Yu Xing Cao

rnScute Root - Huang Qin

rnFeverfew - Tanacetum Parthenium

rnEyebright Herb - Euphasia

rnBurdock Seed - Niu Bang Zi

rnPlatycodon Root - Jie Geng

rnTangerine Peel - Chen Pi

rnMagnolia Bark - Hou Po

rnXanthium Fruit - Cang Er Zi

rnAngelica Dahurica Root - Bai Zhi

rnChrysanthemum Flower - Ju Hua

rnFresh Ginger Rhizome - Sheng Jiang

rnBupleurum Root - Chai Hu

rnPeppermint Leaf - Bo He

rnLicorice Root - Gan Cao

rnPurified Water

rnOrganic Cane Alcohol (20%)