This medicine is a “pharmacist only medicine”, which means we have to record the sale and make sure it’s safe for you or the people taking it.
The ingredients can interfere with some medical conditions and medicines.
Please completed the (yes/no) questions and medication list (if any) Below:
Paihia Bomb’s shouldn’t be given to anybody else without knowing their medical history etc.
We need to record the name and address of each person individually.
We’re limited to selling 10 caps per person @ $39.99 per 10 caps, plus postage of $12.00 (Within NZ Only)
Once you have submitted your questionnaire, we will contact you with any questions, once we are happy with your responses to the questionnaire, we will send you payment details.