Name:
PRODUCT ORDER FORM
CEREAL
** We DO NOT accept refunds/exchanges **
Please check your order carefully to ensure you have the correct items.
$1.50/bag
HOT DRINKS
$9 /box of 7
FILL IT, SHAKE IT, DRINK IT!
$1.75/bottle
Apple Cinnamon
Bags
Amaretto Hot Chocolate*
Boxes
Chocolate Shake
Bottle
French Vanilla
Bags
Cappuccino
Boxes
Vanilla Shake
Bottle
Honey Almond
Cocoa Cereal ($8.50/box)
Bags
5- Pack
Hot Chocolate*
Boxes
Cran-Grape Fruit Drink
Bottle
Hot Chocolate with Marshmallows
Boxes
Kiwi Strawberry Fruit Drink
Bottle
Irish Cream Hot Chocolate
Mocha Hot Chocolate*
Boxes
Boxes
Lemon Razzy Fruit Drink
Pineapple Orange Fruit Drink
Bottle
Bottle
OATMEAL
Apple 'n Cinnamon*
$9 /box of 7
Boxes
Maple 'n Brown Sugar*
Boxes
Vanilla Cappuccino
Boxes
Proticcino (chocolate coffee flavor)
Bottle
Regular
Boxes
Variety Pack
Boxes
Wild Berry Splash Fruit Drink
Bottle
Variety Pack Incl (*) & 1 Mint, 1 Raspberry, 1 Cinnamon
OMELET
Bacon & Cheese*
Vegetable*
PANCAKES
Blueberry*
Chocolate Chip*
Golden Delicious*
BREAKFAST VARIETY PACK
Variety Pack *
$9 /box of 7
Boxes
Boxes
COLD DRINKS
$9 /box of 7
ISOPURE- READY TO DRINK
Alpine Punch
$2 /bottle
Bottle
Lemonade
Boxes
Grape Frost
Bottle
Peach Mango
Proticcino Drink (choc coffee flavor)
Boxes
Boxes
Cocotein - Protein Coconut Water
$4.00
Boxes
Strawberry Kiwi*
Boxes
CORE POWER- READY TO DRINK
Boxes
Wild Berry*
Boxes
Strawberry Banana
Bottle
Variety Pack
Boxes
Chocolate
Bottle
NECTAR
$1.75/packet
$9 /box of 7
Boxes
$9 /box of 7
Boxes
$3 / bottle
Variety Pack Incl (*) & 1 Lemon Razzy, 1 Grapefruit,
1 CranGrape, and 1 Pineapple Orange
Variety pack incl (*) items
Packet
Packet
Packet
Chocolate Truffle
Packet
Crystal Sky
Double Stuffed Cookie
Packet
Packet
$9 /box of 7
Boxes
Beef with Pasta
Boxes
Strawberry Crème*
Boxes
Chicken Bouillon *
Chicken with Pasta *
Boxes
Boxes
SHAKE/PUDDING
Chocolate*
$9 /box of 7
Boxes
Cream of Chicken *
Cream of Mushroom
Cream of Tomato *
Boxes
Boxes
Chocolate Hazelnut
Chocolate Mint*
Boxes
Boxes
Fuzzy Navel
Lemon Tea
Packet
Packet
Boxes
Pink Grapefruit
Packet
Tomato Soup *
Boxes
Boxes
Roadside Lemonade
Packet
Variety Pack *
Mocha*
Boxes
Strawberry
Vanilla*
Boxes
Strawberry Kiwi
Packet
Boxes
Strawberry Mousse
Packet
Boxes
Twisted Cherry
Packet
Vanilla Bean Torte
Packet
Variety pack incl (*) items and 1 Cream of Broccoli
PASTA
$9 /box of 7
Nacho Cheese Pasta
Boxes
Vegetable Chili
Boxes
READY-TO-EAT MEALS
$4.50 /box
Dark Chocolate*
Variety Pack
*
Variety pack incl (*) items
GELATIN
$9 /box of 7
Raspberry
Boxes
NUTRIMED- READY TO DRINK
Strawberry Banana
Boxes
Chocolate
3-Pack
Vanilla
3-Pack
Beef & Bean Enchiladas
Boxes
Beef Stroganoff
Chicken Pasta Parmesan
Boxes
Boxes
Five Bean Casserole
Green Pepper Steak
Boxes
Boxes
Gravy with Beef Pot Roast
Boxes
Pasta Fagioli
Boxes
Spaghetti with Meatballs
Boxes
Blueberry Delight- flavor packs
Spicy Chicken Oriental
Boxes
Turkey Chili with Beans
Vegetable Lasagna
Vegetable Stew with Beef
PASTA
$9 /box of 7
Boxes
Cappuccino
Carribbean Cooler
SOUPS
Beef Bouillon *
Boxes
SMOOTHIES
Berry Crème*
Apple Ecsatasy
PROTEIN SMOOTHIES BASE MIX
Order 1 Flavor pack below for each base mix
NECTAR - 2 lbs
$37 /2 lbs
Cappuccino
Caribbean Cooler
Conatiner
Conatiner
Pick One Flavor for Each Base Mix Purchased:
Chocolate Truffle
Conatiner
FLAVOR PACKS
Double Stuffed Cookie
Conatiner
Boxes
Fuzzy Navel
Conatiner
California Strawberry- flavor pks
Boxes
Strawberry Mousse
Conatiner
Boxes
Chocolate Indulgence- flavor pks
Boxes
Vanilla Bean Torte
Boxes
Chocolate Peanut Butter- flavor pks
Boxes
UNJURY - 1 lb
Boxes
Double Mint Chocolate- flavor pks
Boxes
Chocolate
Conatiner
Orange Creamsicle- flavor packs
Boxes
Vanilla
Conatiner
Chicken Soup
Conatiner
Unflavored ($23)
Conatiner
$8 /box of 4
$12 /box of 7
Boxes
$6 / 3 pack
$3.50/ box of 7
Creamy Chicken
Boxes
Pina Colada- flavor packs
Boxes
Fettuccini Alfredo
Boxes
Vanilla Bean- flavor packs
Variety- includes one of each flavor
Boxes
Boxes
Conatiner
$25 /1 lbs
PRETZELS
BBQ Snack Mix
Bags
Chocolate Coconut
Boxes
IRON + C
Iron + C (30 mg tablet) $8
Cinnamon Toast
Bags
Chocolate Peanut Dream*
Boxes
Iron + C (30 mg chewable) - Grape $10
Jalapeno Honey Mustard
Bags
Chocolate Mint
Boxes
Iron + C (30 mg chewy) - Choc Rasp $15
Bags
Cinnamon Raisin*
Boxes
$1.50/bag
Lemon Meringue*
Boxes
Original Pretzel Sticks
CRUNCHY/CRACKERS
$1.50/bag
CRISPY
$10.50/box of 7
Chili Nacho Cheese
Bags
Peanut Butter*
Boxes
MULTIVITAMINS
Multivitamin (capsule) $16
Crispy Parmesan
Bags
Peanut Butter and Jelly*
Boxes
Multivitamin (soft chew)- Very Berry $24
White Cheddar
Bags
Cinnamon
Boxes
Multivitamin (soft chew)- Orange $24
Double Berry
Boxes
Multivitamin (chewable) - Grape $16
CHIPS
$1.50/bag
Barbecue Crunch
Bags
Fudge Graham
Boxes
Multivitamin (chewable) - Mandarin $16
Pizza Crunch
Bags
Peanut
Boxes
Multivitamin (chewable) - Pineap Straw $16
Ranch Crunch
Sea Salt & Vinegar Crunch
Bags
Bags
Variety Crispy
Boxes
COOKIE BITES
Cinnamon Almond
Honey Almond
PUFFS
Almond Delight
Mac & Cheese
ZIPPERS
Barbecue
Sour Cream and Herbs
$1.50/bag
DUODENAL SWITCH ONLY
Variety pack incl (*) items
LAYERED
$10.50/box of 7
Multi-ADEK (capsule) $ 23
Multi-ADEK (chewable) - Berry Sorbet $ 23
Bags
Caramel Brownie*
Boxes
Bags
Caramel Crunch*
Boxes
Caramel Nut
Boxes
Bags
Chocolate Marshmallow
Boxes
VITAMIN D
Vitamin D 5,000 IU - Dry Capsule $8
Bags
Cinnamon Oatmeal
Boxes
Vitamin D 5,000 IU - Sublinguil Orange $11
Cocoa Mint
Dark Chocolate S'mores
Boxes
Boxes
Nutty Caramel Crunch
Boxes
VITAMINS & MINERALS
Vitamin B12 - Sublinguil Cherry $16
$1.50/bag
$10 /box of 7
Boxes
Boxes
Peanut Butter*
Boxes
Biotin (5 mg capsule) $15
Caramel Covered Soy Puffs
Boxes
Peanut Caramel Delight
Boxes
Copper 3 mg $10
Choc Covererd Soy Puffs
Boxes
Peppermint Cocoa Crunch
Boxes
Vitamin A 10,000 $8
Strawberry Cheesecake*
Boxes
Devrom $16
Supreme Peanut
Boxes
Probiotic - Strawberry $23
Variety Layered
Boxes
SOY PUFFS
GRANOLA
Chocolate and Caramel
BEEF & OSTRICH
$12 /box of 7
$10 /box of 7
Boxes
$1.50/each
BBQ Stick
Sticks
Variety Pack Incl (*) Layered Items & Oatmeal,
DRESSING
Natural Stick
Sticks
Rockie Road and Double Peanut Butter
Honey Mustard
Boxes
Pepper Stick
Pepper Jerkee
Sticks
Jerkee
Variety Pack Incl: 1 Cookies & Cream, 1 Supreme Peanut,
Itailian
PB2 POWDERED PEANUT BUTTER
Boxes
$4 /Jar
1 Nutty Caramel Crunch, 1 Triple Chocolate,
Peanut Butter Jar
Jars
1 Cocoa Mint, 1 PB Cup, 1 Cinnamon Oatmeal
Peanut Butter w/Chocolate Jar
PB2 POWDERED PEANUT BUTTER
Teriyaki Jerkee
TURKEY
Applewood Stick
Maple Brown Sugar Stick
BEEF AND ELK
Jerkee
$1.50/each
Sticks
Variety Proti
COOKIES
Boxes
$10.50 /box of 7
$6 /box of 14
Jars
$1 /Packet
Sticks
Chocolate Chip w/ Icing
Boxes
Peanut Butter Packet
Packets
$1.50/each
Oatmeal Raisin w/ Icing
Boxes
Peanut Butter w/Chocolate Packet
Packets
RD RECOMMENDATIONS
Complete Food Counter (book)
$7.00 each
Habenaro
Sweet and Spicy Stick
Sticks
Sticks
WAFERS
Chocolate
Teriyaki Stick
Sticks
Mocha
Boxes
Drink Mixer
$8.75 each
Vanilla
Boxes
Food Scale
$8.75 each
GHP Blender Bottle
$7.00 each
QUEST BARS
$2.25/bar
$10.00/box of 5
Boxes
Banana Nut Muffin
Bars
Chocolate Peanut Butter
Bars
CALCIUM
Cinnamon Roll
Bars
Calcium 250 mg Soft Chews - Berry $11.50
GHP Fabric Reuseable Bag
Exercise Bands - Light
Med
Coconut Cashew
Bars
Calcium 250 mg Soft Chews - Chocolate $11.50
Door Ancor
Double Chocolate Chunk
Bars
Calcium 500 mg Berries & Cream $20
2 Cup Container
Lemon Cream Pie
Bars
Calcium 500 mg Cherry Tart $20
Lunch Set
$9.75
Strawberry Cheesecake
Bars
Calcium 500 mg Orange Burst $20
$6.75
$5.75
Calcium 500 mg Soft Chews - Caramel $31
Cookies N' Cream
Bars
Calcium 500 mg Soft Chews - PB Choc $31
Beck Diet for Life_____ $20
Peanut Butter
Bars
Calcium 500 mg Creamy Bites - Choc $14.50
$1.50 /bar
$20 Workbook
Calcium 500 mg Creamy Bites - Lemon $14.50
Bars
2060 East Paris Ave. Suite 100 ● Grand Rapids, MI 49546 ● Phone (616) 956-6100 ● Toll Free (888) 691-0050 ● Fax (616) 956-6637 ● Store (616) 464-4659
Triple Chocolate Fudge
$10.25ea.
$10.00
Snacker Set
Beck Diet Book
HEALTHSMART 95/100 cal
$3.75 each
Heavy
$14