Triple-Action Performance Formula

Doctor’s Choice ED Combo Troche

Triple-Action Performance Formula

Get Your Ed Combo Troche Now

Fill out the form below to order your ED treatment, combining Apomorphine, Tadalafil, and Sildenafil for unmatched results.

Don’t worry if you don’t have a prescription; our team is here to assist you in obtaining one quickly and easily.

Please enable JavaScript in your browser to complete this form.

- Step 1 of 6

Are you currently located in California? *

Do you already have a prescription for the ED Combination Troche? *

How long have you been experiencing erectile issues?

Less than 6 months
6–12 months
Over a year

How would you describe the severity?

Mild
Moderate
Severe

How often are you able to achieve an erection firm enough for intercourse?

Always
Sometimes
Rarely
Never

Are your symptoms primarily:

Difficulty getting an erection
Difficulty maintaining an erection
Both

Have you used any ED medications before?

Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Over-the-counter supplements
None

If yes, did they work for you?

Are you currently in a stable sexual relationship?

Do you have any of the following conditions?

Heart disease
High blood pressure
Low blood pressure
Liver disease
Kidney disease
Diabetes
Depression / Anxiety
None

Are you currently taking any of these medications?

Nitrates (Nitroglycerin, Isosorbide)
Alpha blockers
Blood pressure medications
Chronic pain meds / opioids
None

Have you ever been diagnosed with low testosterone?

Have you had recent heart-related events (angina, stroke, or heart attack)?

Do you use alcohol, smoke, or recreational drugs?

Alcohol
Tobacco
Recreational drugs
None

Upload a clear photo of your ID (for telehealth verification) *

Drag & Drop Files, Choose Files to Upload

Do you understand that this troche contains Apomorphine, Tadalafil, and Sildenafil?

Do you understand possible side effects (flushing, dizziness, headache, nausea, or low blood pressure)?

Do you agree to follow the dosing instructions: place one troche under the tongue, let it fully dissolve, do not chew or swallow, and do not exceed one troche in 24 hours?

Do you agree to stop using the medication and contact the pharmacy if you experience side effects?

Do you understand that effects may begin within 15–30 minutes and last up to 36 hours due to Tadalafil?

Upload your prescription (if you already have one)

Drag & Drop Files, Choose Files to Upload

Price Acknowledgment *

I acknowledge the cost: $12 per troche, $80 for 10 troches,

Price Acknowledgmen *

I acknowledge the cost: $12 per troche, $80 for 10 troches, anf $50 for consultation fees

Telehealth & HIPAA Acknowledgment *

I consent this form will be reviewed by a licensed California provider.
I understand that my information is protected under HIPAA and will remain confidential.
I confirm that I am physically located in California and eligible for this service.

Discount Code (Optional)

Full Name *

Date of Birth *

Phone Number *

Gender *

Male
Female

Email Address *

Shipping Address *

Address Line 1

Address Line 2

City

State

Zip Code

Digital Signature (Type Your Name) *

Doctor’s Choice ED Combo Troche