        CLINICAL FORMULATION DISPENSARY // COLD-CHAIN & AUTO-RITUAL
      

Beverly Canon Skin — Clinical Regimen & Cold-Chain Prescription Checkout

            01 // PATIENT / CLIENT RESIDENCE & INSULATED COLD-CHAIN COURIER
          

Full Name / Contact

Notification / Invoice Email

Delivery Street / Dock / Lab

Suite / Bay / Gate

City, State ZIP

            02 // 3 COMPLIMENTARY SAMPLE VIALS & 30-DAY AUTO-RITUAL CADENCE
          

30-Day Auto-Ritual Refill (-20%)

Priority cold-chain batch + 3 sample vials every 30 days.

Single Formulation Order

One-time clinical specimen dispatch with 3 sample vials.

              ✓ 3 Complimentary Botanical Sample Vials Added: Resurrection Balm, Parsley Seed Serum & Hinoki Cleanser
            

            03 // HSA / FSA WELLNESS BENEFIT CARD & RECURRING RITUAL BILLING
          

Card / Account / Net-30 Reference

Expiration

Security Code

Billing address matches verified Beverly Hills delivery coordinates (412 N Canon Drive, Beverly Hills, CA 90210)

          ORDER MANIFEST & LIVE SETTLEMENT
        

Local Beverly Hills Fulfillment $0.00 (INCLUDED)

Territory Guarantee & Care Kit ACTIVE

Total Settlement $0.00