

✔️ Includes: 6 Boxes of Aquoral Spray
✔️ 1 box contains (2) 10mL bottles
✔️ 1 box shipped every 2 months for 12 months
✔️ *$24 health intake review is required once every 12 months (Included in price)
Patient Info
Required Health Questions
Prescription Information and Approval:
Because this is a prescription medication a health intake is required for a doctor to review. Please answer brief medical questions and medication information
Gender
Height and Weight
Symptoms. Please select all that apply
Do you have any known allergies to medications or ingredients (such as aspartame or silicon dioxide)?
I understand Aquoral contains aspartame (a sweetener), and should not be used by individuals with PKU (phenylketonuria), a rare genetic disorder.
I do not have PKU and agree to proceed.
Payment and Shipping
⬇️ Autoship confirmation $60/ every 2 months
Acknowledgment & Consent
I understand my order may not be canceled or refunded except as required by law. Subscription renewals may be canceled by calling, emailing, or texting support at least forty-eight (48) hours before the next payment.
I understand Aquoral Spray is for dry mouth symptom relief only, does not replace care from my in person healthcare provider, and I will stop use and contact a provider if I experience side effects.
I confirm my information is accurate, agree to Vouched e-identity verification, and consent to receive text, email, call, communications, with the option to opt out by contacting support.
IMPORTANT: Please be advised that due to State Laws once you authorize shipment and the medication leaves the pharmacy, it may not be returned under any circumstances. Once order is submitted, it cannot be altered or cancelled.
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