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Biobuilt Order & Intake
Fill this out to place an order - we'll confirm details & payments on WhatsApp
Your Name
*
Best way to reach you
*
Best way to reach you
A
Whats App
B
Text
C
Instagram DM
D
Email
Your number, @handle or email for that method
*
Have you ordered from us before?
*
Have you ordered from us before?
A
YES
B
NO
Peptide
*
Setup type
*
Setup type
A
Initial setup (with pen)
B
Refill ( I already have my pen)
C
Disposable pen
D
DIY vial
Quantity
*
Additional items?
Add-ons (optional)
Add-ons (optional)
carrying case (+6)
Extra pen needles (10 ct +$2)
Insulin syringes (10 ct +$3.50)
BAC water 2.4 ml (+$4)
DIY reconstitution kit (+$8)
Pen Cartridge holder replacement (+$6)
Delivery preference
*
Delivery preference
A
Community pickup in Tres Lagos - free
B
Within 5 mi of Tres Lagos - free
C
Local 5-10 mi from Tres Lagos (+$5)
D
USPS mail (+$10)
Submit
