| # | Order ID | Form | Name of Customer | Address | Status |
|---|---|---|---|---|---|
| 1 |
GO-693376b1769c1194381958
12/05/2025 07:20 |
biofusion.com | Sally Martinez | 1350 Northwest U.S. Highway 27 Chiefland, Florida - 32626 | awaiting_shipment |
| 2 |
GO-69336738ca573374680170
12/05/2025 06:14 |
PharmacyChiefs.com | Mark Milburn | 30 Avebury Cove Eads, Tennessee - 38028 | awaiting_shipment |
| 3 |
GO-693362640cba5445700731
12/05/2025 05:53 |
PharmacyChiefs.com | Terry Smith | 133 N Chalkville Rd Suite 1 Trussville, Alabama - 35173 | awaiting_shipment |
| 4 |
GO-693360cb3d30a452344020
12/05/2025 05:46 |
medicalweightlossclinics.com | Julie, Tenette | 6574 Ariel Court Riverside, California - 92506 | awaiting_shipment |
| 5 |
GO-6933584116b7b782767938
12/05/2025 05:10 |
advancedmedspaofficial.com | Romy Fontoura | 2700 N Miami Ave. Suite 404 Miami, Florida - 33127 | awaiting_shipment |
| 6 |
GO-69335836b54a5332654927
12/05/2025 05:09 |
vestrameds.com | Diane Walker | 27411 W Yukon Dr Buckeye, AZ - 85396 | awaiting_shipment |
| 7 |
GO-6933562849273301125477
12/05/2025 05:01 |
PharmacyChiefs.com | Blondena Miley | 2010 Injo Dr Lake Havasu City, Arizona - 86403 | awaiting_shipment |
| 8 |
GO-69331ae263bc0872584875
12/05/2025 12:48 |
theembodiedwellness.com | Deanna Lord | 735 3rd Ave Sacramento, CALIFORNIA - 95818 | awaiting_shipment |
| 9 |
GO-693314bf0ece4348935552
12/05/2025 12:22 |
theembodiedwellness.com | Tina Childs | 3320 Marconi Ave Sacramento, CA - 95821 | awaiting_shipment |
| 10 |
GO-69330df293f34225212247
12/05/2025 11:53 |
advancedmedspaofficial.com | Romy Fontoura | 400 Tradecenter Dr. Suite 1950 Woburn, Massachusetts - 01801-7410 | awaiting_shipment |
| # | Order ID | Form | Name of Customer | Address | Status |
|---|---|---|---|---|---|
| 1 |
GO-6932c7fe8bcda201376235
12/05/2025 06:55 |
Demosite.com | TEST EMAIL SENDING | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
| 2 |
GO-6932894bea85c567837365
12/05/2025 02:32 |
Demosite.com | TEST EMAIL DOC APPROVAL | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
| 3 |
GO-a0ec097471ec51255
12/04/2025 01:45 |
scale.thinnex.com | Diane Jackson | 260 Hickory Pointe Drive Acworth, GA - 30101 | For Doctor's Approval |
| # | Products | SKU | Title | Qty | Price |
|---|
| Patient Name (First, Last) |
SEX |
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| DOB | Cell Phone | |||||
| Shipping Address | ||||||
| Required Patient Information (Fill out or attach demographics with fax) | |
| Allergies (if none, must write none) |
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| Current Medications (if none, must write none) |
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| Driver's License # | |
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| Facility Name | Facility Phone | ||
| Facility Address | |||
* If Provider is a NP/PA a Supervising Provider is required for a Controlled Substance (or a Standing Order must be on file) *
| Doctor Name Goes Here | |
|---|---|
| Docotors' Notes Content Here | Edit |
| # | Order # | Card No. | Amount | Discount Code Discount Type Discount Amount |
Invoice | Invoice Created |
Is Paid | Is Refunded | Payment Status |
|---|
| # | Order # | Prescription Order No. |
Name | Medication | Refill No | Days Supply | Refills | Order Status |
Canceled At |
Tracking No. |
Shipping Provider |
Date Delivered |
|---|
| Patient Name (First, Last) |
SEX |
|
||||
| DOB | Cell Phone | |||||
| Address | ||||||
| Required Patient Information (Fill out or attach demographics with fax) | |
| Allergies (if none, must write none) |
|
| Current Medications (if none, must write none) |
|
| Driver’s License # | |
|
|
|
| Facility Name | Facility Phone | ||
| Facility Address | |||
* If Provider is a NP/PA a Supervising Provider is required for a Controlled Substance (or a Standing Order must be on file) *