Practitioner request


                                            

My patient  is interested in taking the medical food KetoCitra for the daily dietary management of individuals with mild to moderate stages (CKD stages 1-3) of autosomal-dominant polycystic kidney disease (ADPKD). 

Please contact them by phone at to provide a free sample for a month supply of KetoCitra.

 

Patient

Practitioner

  

Email to send sample code

PRACTITIONER REQUEST FORM:

I have my patient’s permission to provide their information to Santa Barbara Nutrients. I
recognize that no medical advice or information will be shared or discussed with my patient on behalf of
Santa Barbara Nutrients.

Leave this empty:

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Document name: Practitioner request
lock iconUnique Document ID: 5969a93232b9879fe4414b5a442b3590c2fc44a1
Timestamp Audit
September 24, 2021 12:16 pm PSTPractitioner request Uploaded by David Stagnitto - stagnitto@sbnutrients.com IP 24.213.151.4
October 6, 2021 1:08 pm PST Document owner stagnitto@sbnutrients.com has handed over this document to practitioners@santabarbaranutrients.com 2021-10-06 13:08:21 - 24.213.151.4