Licensed Retail Online Order Form
Complete the brief form below and your order will be on its way!
First and Last Name
Intake Contact Name
Preferred Intake Contact Information
50mg Cranberry Almond Paleo Bar
If you would like to place an order for both samples and cases, please check both applicable boxes
Medicated Sample Pack (3 bars) - $0 [Licensed Retailers Only]
1 Case (24 bars) - $200
2 Cases (48 bars) - $400
3 Cases (72 bars) - $600
4 Cases (96 bars) - $800
6 Cases (144 bars) - $1,000 [ BUY 5, GET 1 FREE ]
When Would You Like Product Delivered?
We deliver Monday, Wednesday and Friday. If no date is specified, we'll simply deliver at the next available delivery day!
Retail Intake Delivery Address
Questions, Comments or Instructions
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