21 For Life: Registration - Debbie Stevenson

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21 For Life

*Your base price of $97 includes shipping and handling. Price may vary by $5 depending on shipping costs to your area. If you choose add-ons they will be totaled at the end.

Price: $97.00

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Billing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Shipping Address

If different from billing address.

Street Address City State / Province / Region ZIP / Postal Code Country

Email*

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Smoothie Selection

Your 21 For LIFE program includes one bag of yummy MySmartShakes - gluten free, certified low glycemic meal replacement where you get to pick your protein base and flavor optimizers for your shakes. Please select your protein base below - Whey, Soy, or Plant. This will be delivered right to your front door.

Protein Base*

Please select one flavor

Whey
Soy
Plant

My SmartShakes Flavor Optimizers*

Please select a total of 2. You may pick 2 of the same flavor or 2 different flavors.

Dark Chocolate Flavor	Milk Chocolate Flavor	Peach Mango Flavor	Strawberry Flavor	Green Tea Flavor	Cappuccino Flavor	Banana Flavor

Program Add-Ons

Below is a list of additional health items that can enhance your program. Our product partner supplies the best pharmaceutical-grade health products at competitive prices, so you always know you are getting the best on the market.

Digestive Enzymes (56 tablets/bottle)

Excellent for people who have a hard time digesting food. Supplies enzymes to support normal digestion and optimal macronutrient absorption. Enzymes support the breakdown of dietary carbs, fats, and proteins. It encourages more complete digestion and absorption of nutrients while supporting the body’s natural detoxification processes.

Price: $33.00 Quantity:

Fiber (28 servings)

Did you know less than 10% of Americans get the recommended 21-38 grams of fiber in their daily diet? A diet high in fiber can help you maintain a healthy digestive system and great long-term health. Our product contains 12 grams of dietary fiber per serving (1 rounded Tablespoon) , is gluten-free, dairy-free, soy-free and is made with all natural ingredients.

Price: $34.10 Quantity:

Probiotics (14 stick packs/box) - Supports Healthy Digestion

This probiotic is unlike competing products because it contains Lactobacillus rhamnosus LGG® and Bifidobacterium BB-12®, two strains of specific probiotic bacteria clinically proven to survive the harsh acidic environment of the stomach. Another advantage is that its dairy- and sugar-free delivery system ensures that the bacteria will be stable at room temperature for over a year.

Price: $29.70 Quantity:

Fish Oil supplement (56 capsules/bottle) - High-quality, ultra-pure, toxin free

Provides advanced and guaranteed levels of EPA and DHA, two long-chain omega-3 fatty acids important for memory and learning. Supports sound cardiovascular, immune, health and joint health. Critical for promoting healthy pregnancies and healthy babies. Each Capsule - 1000 mg fish oil + 100 IU Vitamin D. Pharmaceutical quality.

Price: $25.30 Quantity:

Please list any allergies or food sensitivities you have.*

Indicate allergy or sensitivity. Also list if there are any foods that you do not consume. If you don't have any, please type NONE.

Are you currently taking any nutritional supplements or medication?*

Please list all.

Anything else you would like us to know?

Did someone refer you to the program? Let us know who!

We love to thank our referral partners.

Are you an associate with Usana Health Sciences?*

Disclaimer*

*As with every health & wellness program, please check with your medical doctor before starting this program. The information in the 21 For Life Program is meant for educational purposes only. The information in this program is not intended to serve as medical advice and should not be used for the diagnosis or treatment of a health problem or disease. This program is not a substitute for professional medical care.

Yes, I have read the disclaimer and agree to the terms stated.

Total (includes any supplements added)

$0.00

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