Soothe & Moisten (PeeKay)

Apply Custom Rx Label ?

* Fill Out the Information Below for Custom Labelling

Reference Name*:

(For your records)

Formula Label Name:

(To be printed on label)

Pharmacy Instructions:

Kamwo Suggestions:

dosing instructions

Manufacturer Label Unit Size:

Manufacturer Label Dosages:

Take 5 to 10 squirts, 2-3 times per day, or as directed by your health care provider.

Manufacture spoonful (1.0g)

Capsule (0.7g)

Times Daily:

Number of Days:

---- OR ---- Click checkbox to add Instructions.

Custom Instructions:

(60 charecters max)

Refills:

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* Creating and Using Custom Labels what does create and use custom label mean?

Kamwo replaces the Manufacture's label with a Rx label with custom info entered by practitioner.

why should I create a custom label?

Manage patient dosing by specifying number of refills.

Prevent patient from self-medicating (without practitioner consultation) by buying medicine with manufacture label.

Add retainer (for practitioner effort) with a total price that is above product's retail price.

PATIENT NAME: The name of the patient whom this product is intended to be used by.

Formula Label Name: Name of the formula used in the prescription.

Unit Size: Size of the prescription, based on grams and the number of bottles.

Custom Practitioner Dosing Instructions: Choose from preloaded instructions or create your own set.

Date Filled: The date that the prescription was filled for the patient.

Expiration Date: The date that the product is best used by.

Rx Number: Number allocated with the prescription.

Practitioner Name: The patient's prescribing Practitioner's full name.

Description:

Patent Formula Name

Alternative Name

Product Line

Peekays by Paul Kempisty, L.Ac

Dosage Forms

Tincture

Unit Size

Dosage

Take 5 to 10 squirts, 2-3 times per day, or as directed by your health care provider.

Allergy Warning

Ingredients

Aloe vera juice

rnOphiopogon root

rnAsperagus root

rnRehmannia raw root

rnScrophullaria root

rnPrickly Ask bark

rnSlippery Elm bark

rnMarshmallow root

rnChrysanthemum flower

rnAnemarhena root

rnForsythia fruit

rnHoneysuckle (Lonicera) flower

rnLily Bulb

rnFritillaria root (Chuan Bei Mu)

rnDendrobium

rnPueraria (Kudzu) root

rnPlatycodon root

rnGypsum mineral

rnPurified Water

rnOrganic cane alcohol (20%)