Print this page  (after obtaining a prescription from your doctor) for ordering Progesterone. Fill in the blanks and mail to Starks Professional Pharmacy along with your prescription:

Stark Pharmacy
Menorah Medical Center
119th & Nall - 5701 W. 119th
Overland Park, Kansas  66209-3721

  For Pharmacy information telephone:1-913-345-3800.  Sorry, no international orders.

This form must beTelephoned in by your Doctor or mailed to the Pharmacy by you !!!
Progesterone: In a 10% solution one drop contains about three milligrams of progesterone. $44.95 per 28ml bottle
This price includes shipping. Your Credit Card Will be Charge the Checked  Amount

Use Scotch Tape to Attach Your Prescription Here

 

Credit Card and Shipping Information

Card Holders Name

Credit Card, Visa, MasterCard, Amex

Credit Card Number

Expiration Date

Street Address
City
State
Zip Code
Email Address