Request a Custom Quote (NOT AN ORDER)
$6.50 will be added to all orders for delivery.
This form is to be used to request a price for a custom compounded prescription. The order will NOT be filled until the quote is approved. If you would like to place an order for a custom compounded prescription, please complete our CUSTOM ORDER FORM.
NOTE: Please do not include any identifying information about human patients, as this form is secure, but not HIPAA-compliant.
This form is to be used to request a price for a custom compounded prescription. The order will NOT be filled until the quote is approved. If you would like to place an order for a custom compounded prescription, please complete our CUSTOM ORDER FORM.
NOTE: Please do not include any identifying information about human patients, as this form is secure, but not HIPAA-compliant.