Product Reorder Form

We make it easy to continue your skin care program!

Reordering your skin care products is as easy as just a few clicks of your mouse!  For your convenience, we now accept online skin care orders.

For your personal identity security, we only accept credit card numbers by telephone or in person.  Please DO NOT include your credit card number on this form. Once you place your order, we will contact you via telephone to complete the process. For your convenience, we accept Visa, MasterCard, debit cards, checks and cash.  You will be charged a shipping and handling fee for mail orders.

If you have not been seen by Dr. Pacheco for your follow-up skin care appointment in the last six months, we may ask you to schedule an appointment to review your progress or to adjust your regimen before filling out your product reorder form.

Your Name (required)

Your Email (required)

Phone (required)

Pick up at our office Mail 

Shipping Address

Product Needed
Please write the exact name of the product and fluid oz. as it reads on the product container.

Please allow 24 to 48 hours for our office to contact you to complete your order.

 

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