ETX Peptide Rx Web Form

Kelly Warren, M.D (Supervising Physician)

East Texas Inject | www.etxinject.com | Phone: 903.802.5167| Krystal Gilmore, FNP 

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Rx · Select Compound(s) And Complete Sig / Quantity

Tissue Repair & Gi Health

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 2.5 mg/mL Inject 10 units subcutaneously before bed 3 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Oral Capsule 500 mcg each Take 1 capsule by mouth once daily before bed 90 count

GI HEALTH & IMMUNE SUPPORT

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Capsule 2.5 mg/mL Inject 10 units subcutaneously before bed 3 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 2.5 mg/mL Inject 10 units subcutaneously daily 3 mL vial

GROWTH HORMONE OPTIMIZATION

Sig / Directions 
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 1 mg / 1 mg / mL Inject 10 units subcutaneously in the evening, 5 days on / 2 days off, away from food 2 mL vial

ANTI-AGING & REGENERATIVE

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 12 mg/mL Inject 10 units subcutaneously 3 times weekly or daily per protocol 2 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Oral Capsule 4 mg each Take 1 capsule by mouth daily 90 count
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Topical 3.0% (or custom) Apply topically as directed 30 g

COGNITIVE & NEUROPROTECTION

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 2.5 mg/mL Inject 10 units subcutaneously once daily in the morning, 5 days per week 3 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Nasal Spray 7.5 mg/mL 1 spray in each nostril once daily in the morning, 5 days per week 10 mL bottle

TISSUE REPAIR & RECOVERY

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 3 mg/mL Inject 300 mcg subcutaneously once daily 3 mL vial

METABOLIC & MITOCHONDRIAL

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 20 mg/mL Inject 10 units SQ in the morning on an empty stomach, 5 days on, 2 days off 2 mL vial

CELLULAR ENERGY & LONGEVITY

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 100 mg/mL Inject 10 to 50 mg subcutaneously twice weekly 3 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Nasal Spray 200 mg/mL 2 sprays in each nostril every morning 10 mL bottle

SEXUAL WELLNESS & VITALITY

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Injection 5 mg/mL Inject 2 mg subcutaneously as needed, up to twice weekly, 45 min prior to desired effect 5 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
Nasal Spray 10 mg/mL 1 spray in each nostril as needed, up to twice weekly, 45 min prior to desired effect 10 mL bottle

COMBINATION VIALS

Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
BPC-157 / TB-500 2.5 / 3 mg/mL Inject 10 units subcutaneously before bed or as directed 3 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
GHK-Cu / BPC-157 / TB-500 12.5 / 2.5 / 3 mg/mL Inject 10 units subcutaneously before bed or as directed 3 mL vial
Compound
Formulation Strength / Concentration Sig / Directions Qty / Pack
GHK-Cu / BPC-157 / TB-500 / KPV 12.5 / 2.5 / 3 / 2.5 mg/mL Inject 10 units subcutaneously before bed or as directed 3 mL vial

PROVIDER SIGNATURE & ATTESTATION

Attestation: Patient is under my care; order is for a legitimate medical purpose; patient informed of compounded, non-FDA-approved status.

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