OPTIFAST Online Orders for Current Patients

This form is intended for use only by current patients of the Weight Management Center in either the Winston-Salem or Greensboro location.

Please enter the amount of each product you would like to order; this should be based on an individual serving (i.e., 1 packet instead of 1 box).

You will need to order a 7 day supply of product and must weigh-in at the Weight Management Center to pick up your product.

PLEASE ORDER AT LEAST 12 HOURS PRIOR TO PICKUP TO ALLOW FOR PROCESSING.

All product orders should be checked by the client as we cannot exchange product once it leaves the Weight Management Center Nutrition Shop.

If you prefer, you may also print out the order form and bring it with you. You may also take this opportunity to print the Optifast Weekly Clinic Visit Questionnaire.

By Design OPTIFAST® Product Order Form WMC Country Club location only
OPTIFAST 800 - Ready to drink ($3.70 each)
OPTIFAST 800 - Powder ($3.00 each)
OPTIFAST 800 - Soup ($3.70 each)
OPTIFAST HP - Powder ($3.70 each)
OPTIFAST 800 - Bar ($4.45 each)
OPTIFAST HP - Ready to Drink ($3.95 each)
Beneprotein ($.75 each)
Please tell us when you will be picking up your order.
Please do not type in date, use pop-up calendar or form will not submit