Tonic Formula to Calm Down (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

Unit Size

Dosage

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

Allergy Warning

Ingredients

Bupleurum Root - Chai Hu

Cyperus Rhizome - Xiang Fu

Albizzia Bark - He Huan Pi

Schizandra Fruit - Wu Wei Zi

Biota Seed - Bai Zi Ren

Zizyphus Seed - Suan Zao Ren

Longan Fruit - Long Yan Rou

Passion Flower - Passiflora

Hops - Humulus Lupulus

Valerian Root - Valeriana offic.

Holy Basil - Tulsi

Amber Resin - Hu Po

Frankincense - Ru Xiang

Magnolia Bark - Hou Po

Coix Seed - Yi Yi Ren

Polygonum Stem - Ye Jiao Teng

Skullcap Root - Huang Qin

Sage Root - Dan Shen

Biota Twig - Ce Bai Ye

Dragon Bone Mineral - Long Gu

Oyster Shell - Mu Li

Purified Water

Organic Cane Alcohol (20%)