Patient Registration
and Health Questionnaire

Welcome to our Xymogen® SA – Immune Support store.

Xymogen® South Africa is excited to be able to offer the Xymogen® range of world-class IMMUNE support products directly to you.

In accordance with online sales policies issued by Xymogen® USA, direct sales to you require the completion of a brief Health Questionnaire as part of establishing your online account. Upon submission and approval of this questionaire, you will receive your account information to access the online store.

Should you wish to purchase non-IMMUNE support related products we will gladly refer you to a registered Xymogen® practitioner by clicking on the “Find your nearest Xymogen® stockist” button on our website.

Welcome to the wonderful world of Xymogen®!

In order to purchase products, please complete the following

Health Questionnaire


Have you ever had any health issues relating to the following (currently or in the past)?