PAYMENT FORM - BodyIQ - Stelo and InBody Scan

PAYMENT FORM - BodyIQ - Stelo & InBody Scan

Please complete this form for Skippack Pharmacy’s BodyIQ Metabolic Health Tracking Program and purchase services such as InBody body composition scans and Stelo continuous glucose monitoring devices. These services are not covered by insurance and are available as out-of-pocket wellness tools designed to help you better understand your metabolic health and track your progress over time.Payment is processed at the time the form is submitted. This is not a hold on your credit card — by entering your credit card information below, your card will be charged immediately.If you have any questions before submitting, please contact our team at clinic@skippackpharmacy.com.Once an order is placed through this form, purchases are non-refundable.BOOKMARK THIS PAGE: You may use this same link whenever you would like to purchase additional InBody scans, CGM devices, or BodyIQ program services.
Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Phone Number*

Area CodePhone Number
Email [Please be sure to add clinic@skippackpharmacy.com to your contact list as your "Order Ready" email will come from this email address & may end up in spam if not in your contact list]*
**non Comcast.net email preferred as Comcast email addresses have often gone to spam**
Receiving Your Order

After submitting this form, our team will review your order and follow up with next steps. InBody Body Composition Scans: InBody scans take about 5 minutes and can typically be completed when you come to pick up your medication or anytime during store hours. No appointment is required. If you purchased a scan or membership, simply let our team know when you arrive. Stelo CGM Devices: If you selected in-store pickup, you will receive a text or email notification when your order is ready for pickup. Please wait for this notification before coming to the pharmacy. Our pickup hours are: Monday–Friday: 10 AM – 6 PM, Saturday: 10 AM – 3 PM. If you selected shipping, we will email you tracking information once your order has shipped.
STELO - PICK UP IN PERSON (No additional cost)STELO - SHIP IT TO ME ($10 shipping fee) ***PLEASE MAKE SURE YOU ALSO SELECT "SHIPPING FEE" IN ADDITION TO SELECTING THE MED*** If you don't put a checkmark next to the shipping fee below or see that you've been charged $10 for it at checkout, your order will be delayed.INBODY SCAN - IN PERSON (Only option)
Mailing Address (if Picking Up, Home Address; if Shipping, put address UPS can deliver to) ***WE CANNOT SHIP TO A PO BOX****

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
InBody scansStelo (CGM devices)Bundle (Both InBody scan & Stelo)

My Products

Body IQ

Stelo CGM, 1-month supply (2 sensors)

Normally priced at $99 for 2 sensors

$89.99 Quantity

Stelo CGM, 3-month supply (6 sensors)

Normally priced at $297 for 6 sensors

$239.99 Quantity

InBody Scan (1 scan)

Normally priced at $50 per scan

$30.00 Quantity

InBody Scan (3 scan)

Normally priced at $150

$75.00 Quantity

InBody Scan (6 scan)

Normally priced at $300

$135.00 Quantity

InBody Scan (12 scan)

Normally priced at $600

$240.00 Quantity

Stelo CGM & InBody Bundle

Includes 2 sensors and 1 InBody scan

$99.00 Quantity

SHIPPING FEE

Please ALSO select this option if you would like the CGM Stelo shipped to you.

$10.00

Enter coupon

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

ACH Bank Transfer

Due to the nature of these products, all sales of BodyIQ products/services are final and non-refundable. Please ensure your order is correct prior to signing and hitting submit. **In the rare event that a partial or full refund is approved, a 5% PROCESSING FEE will be deducted from the refund total** This fee reflects the credit card processing costs we incur and are unable to recover. If you agree, please click on the box on the left, sign below and then press the submit button.
If you do not see a thank you confirmation on the next page or get an error (Error 1 -- your card is declining, please try reprocessing with another card, Error 2 - our system issue, please email: clinic@skippackpharmacy.com or text 267-766-0076 to inform us so we can fix it on our end), your submission did not go through and payment is not confirmed. Please keep an eye out in your provided email and check your spam email as well from clinic@skippackpharmacy.com.
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PAYMENT FORM - BodyIQ - Stelo & InBody Scan

Receiving Your Order

Payment Methods