First, Select HCG Diet Program Length

In-Office Price
$397.00

Online price with HCGCHICA discount
$247.00

  • Lose up to 15 lbs!
  • Physician Tele-Consultation
  • HCG from a Licensed US Pharmacy
  • HCG Diet Guidelines, Recipes and Tips Included!
  • UNLIMITED access to our medical staff via phone, email or live chat

In-Office Price
$497.00

Online price with HCGCHICA discount
$347.00

  • Lose up to 15 lbs!
  • Physician Tele-Consultation
  • HCG from a Licensed US Pharmacy
  • HCG Diet Guidelines, Recipes and Tips Included!
  • UNLIMITED access to our medical staff via phone, email or live chat

Now, Let's Select Your HCG Diet Program Type

INJECTIONS

Includes 5,000 IU HCG Includes All Required Supplies & Syringes
(Recommended)

ORAL PELLETS

Includes 10,000 IU HCG Includes All Required Supplies
(Preferred Oral Option)

ORAL DROPS

Includes 5,000 IU HCG Includes All Required Supplies & Oral Syringes

Our Doctors Recommend These Add-Ons

PHASE 3 ULTRA BURN - $147.00

Injections | 10 ml(30 Day Supply)

A custom compounded mixture of fat metabolizing lipotropics, amino acids and vitamins that speed the removal of fat within the liver and prevent excess fat buildup in problem areas.

HCG DIET SUPPLEMENT BUNDLE - $97.00

Nu Image Medical has put together the most important pharmaceutical grade supplements that are highly recommended prior to and during the HCG Diet Protocol. These items will maintain balanced health, aid in weight loss, reduce stress and weight gain cause.

BIOTIN 10K - $29.00

An Ultra potent Biotin supplement to enhance healthy, thicker hair. This product can be very beneficial to anyone experiencing hair thinning or lose due to aging or hormonal issues.

CALCIUM PYRUVATE - $29.00

Calcium Pyruvate is a naturally occurring compound that is used by your body to digest sugars and starches and convert them to energy. The main benefit of this substance is to assist with weight loss by increasing your metabolic rate and burning excess fat and calories. Studies have shown that women who take calcium pyruvate may lose almost twice as much weight as women on the same diet who have not taken it. This supplement has also been reported to help increase energy levels and may assist in reducing blood pressure.

DIGESTI-CLEANSE - $29.00

This gentle deep action colon cleansing system will jump start your diet by gently detoxifying the digestive tract, relieves bloating, slims the waistline and assists in weight loss with immediate results by combining a deep acting proprietary blend of herbs.

DREAMSPA - $29.00

A proprietary blend of ingredients most effective for enhanced sleep and staying asleep to ensure proper rest. What makes it special are specific ingredients that have been found to increase Human Growth Hormone levels, promoting sleep, fat lose, muscle increase, and overall Anti-Aging benefits.

JETFUEL - $29.00

A STRONG supplement that decreases appetite. This stuff may give you the Gitters if you are sensitive to caffeine!

STRESS STOP - $29.00

A proprietary blend of herbs may help enhance your ability to handle stress, support healthy adrenal gland function and maintain your health.

VITABOOST XL - $29.00

Vitamins and Minerals are an essential part of any weight loss program. They help maintain and support adequate nutrients to the tissues, cells and vital organs in the body. They also help in maintaining energy levels especially on a very low calorie diet.

HCG DIET PROTEIN SHAKES - $4.97 e/a

Protein / Meal Replacement packs specifically designed for the HCG Diet Program. Sweetened with Stevia, they assist in reaching your maximum protein and perfect daily caloric intake. Available in:

Chocolate

Vanilla

Strawberry

Patient Information and Medical History Form

Tell Us a Little Bit About You

Your First Name First name is required.

Your Last Name Last name is required.

Your Email Address Email is required.

Confirm Your Email Address Confirmation email is required. Confirmation email must match email.

A little more about you

Your Date of Birth Date of birth is required. Date of birth is invalid.

Gender Gender is required.

Contact Information

Patient Home Address (Shipping Address | No PO Boxes) Address is required.

Country Country is required.

State State is required.

STATE State is required.

City City is required.

Zip Code Zip code is required.

Cell Phone Number Cell phone is required.

Home Phone Number (Optional)

Primary Physician Information

Primary Physician Primary physician is required.

Physician Phone Number

Reason For Seeking Treatment Reason for treatment is required.

Basic Examination

Patient Height Height is required.

Patient Blood Pressure Blood pressure is required.

Patient Weight Weight is required.

Patient Pulse Pulse is required.

Product Usage

Tobacco How Often An answer is required.

Caffeine How Often An answer is required.

Alcohol How Often An answer is required.

Other Product Usage

Allergies (Select all that apply)

A selection is required.

Other allergy is required.

Over The Counter Medication

A selection is required.

Other medication is required.

Past/Present Medical Conditions

A selection is required.

Other condition is required.

Current Medications, Vitamins, and Supplements

A selection is required.

Are you currently taking any other medications, supplements, or vitamins?

Supplements Name Name is required.

Strength Strength is required.

Last Date Consumed Last date consumed is required. Last date consumed is invalid.

Dosage/Day Dosage is required.

Family History (Father, Mother, Sibilings only)

A selection is required for each condition.

Heart Disease

Relationship is required.


High Blood Pressure

Relationship is required.


Diabetes

Relationship is required.


Arthritis

Relationship is required.


Skin Disorders

Relationship is required.


Cancer

Relationship is required.

Woman Only

= required

ANY BREAST/FEMALE ORGAN CANCER? An answer is required.

ARE YOU CURRENTLY PREGNANT? An answer is required.

ARE YOU CURRENTLY BREAST FEEDING? An answer is required.

HAVE YOU EVER HAD AN ABNORMAL PERIOD CYCLE? An answer is required.

LAST MENSTRUAL CYCLE? (MM/DD/YYYY) An answer is required. Last menstrual cycle date is invalid.

Weight-Loss Consumer Bill of Rights 501.0575

“Off Label” Use of HCG
Statement from the FDA

PATIENT AUTHORIZATION AGREEMENT AND CONSENT

TERMS & CONDITIONS

ONLINE ORDERS

PAYMENT & SHIPPING

= required

SHIPPING METHOD Shipping method is required.

PAYMENT METHOD Payment method is required.

COUPON CODE

Please mail your check to:

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