Credit Card Charge Authorization Form Agreement for Purchase of Compounded Office Use Medication Practitioner Statement Regarding Office Visit Requirements Copy of Practitioner’s Active State License Copy of Active DEA License (if ordering...Account Setup Packet • July 11th, 2019
Facility Information Credit Card Authorization Agreement for Purchase of Compounded Office Use Medication Practitioner Statement Regarding Office Visit Requirements Acceptance of Return Policy Essential Copies of Approved Drug ProductsAccount Setup Packet • April 9th, 2021
