Prescriber Referral Forms

 

Referral Forms Can Be Faxed to:

1-888-275-7908

Please also fax all applicable demographics, labs, & medication history

Compounding

Specialty

BHRT

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Hepatitis C

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Men’s Health

HIV/AIDS

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Women’s Health

GI Medications

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Dermatology

Dermatology A-G

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Scar & Wound Therapy

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Dermatology H-R

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GI Compounds

Dermatology S-Z

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