Physician Recommended Nutriceuticals
 
Doctor Information
  Doctor *
  Invalid Partner Code
     
Patient Information
  First Name *
  Last Name *
  Primary Number (Mobile Preferred)*
Secondary Number
  Email
  * Please provide both email and phone - this gives the patient more options to establish home delivery to suit their preference
  Preferred Language*
Recommendation Made for...*
   
  * Check box to confirm that patient has consented to having PRN contact them by phone, email, and/or text to follow-up on product recommendations, and understands that while PRN will protect the privacy and security of their information, that is also dependent on the carrier's privacy and security measures, which are beyond PRN's control.
   
Recommendation
  Product *
  2nd Product
  Product *
  Doctor Notes
 
 


Simple Instructions

Click Submit after completing the required fields.
A PRN product advisor will contact your patient within 24-48 hours to answer remaining questions and assist in home-delivery set up.

PRN products

PRN USA - Physician Recommended Nutriceuticals
5 Sentry Park East, Suite 210
Blue Bell, PA 19422
Customer Service: 800.900.2303
www.prnomegahealth.com
PRN Canada - Physician Recommended Nutriceuticals
573 5e Rue Shawinigan
Quebec Canada, G9T-4R9
Customer Service: 800.776.6439
www.prnomegahealth.ca