For a printable version of how to write for a compounded prescription, click here
Please note that all compounds for office use require a written prescription for each individual patient.
Medication will be dispensed in patient specific package with patient specific label.
Pt. Phone: ___________________
(please indicate it’s a compounded prescription)
Generic name of active ingredient(s) / Strength or Dose (i.e. % or mg)
Dosage Form (i.e., Transdermal, suppository, capsule, troche)
Doctor name (print): ________________
Doctor phone: ___________________
Please contact our pharmacy for specific questions regarding formulations: 1.866.883.8868 (toll free)
Watch Mike Collins R.Ph. and Amy Dwyer R.Ph. , Nutritionist on the PBS, Life After 50 program
Mike Collins R.Ph., FIACP speaks about pain medications
Amy Dwyer R. Ph. Nutritionist speaks about supplements
Mike Collins R.Ph., FIACP speaks about the art of compounding
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Michigan Pharmacists Association
*Products not intended to diagnose, treat, cure or prevent any disease. Statements have not been evaluated by the FDA.