Writing Prescriptions


Click here for a printable version of “How to Write for Compounded Prescriptions”


Rx     Patient: _____________________________


             Address: ____________________________

             City/St/Zip: _______________________

             Home phone:____________________

             Work Phone: _______________________

             Allergies: ____________________________

Compounded Medication
(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)



Quantity _____________________

Sig _____________________________________________ 


Physician (print): ________________________________

Physician phone: ________________________________

Physician signature: ______________________________


Please contact our pharmacy for specific questions regarding formulations: 989.791.1691 or 866.883.8868 (toll free)

Check out the photos of where our tote bag has traveled!

Watch Mike Collins R.Ph.  on the PBS, Life After 50 program
Mike Collins R.Ph., FIACP speaks about pain medications
Mike Collins R.Ph., FIACP speaks about the art of compounding



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Keri Topouzian Anti-Aging & Functional Medicine, Naturopathic, Holistic, Alternative and Homeopathic Medicine







Michigan Pharmacists Association




International Academy of Compounding Pharmacists




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*Products not intended to diagnose, treat, cure or prevent any disease. Statements have not been evaluated by the FDA.