Prescribers
Select any one of the links below to find out more information.
Referral Process
Referral Process for Narcotics
Request Prescription Pads
Request a Visit from Your Regional Consultant
Request for Prescription Pads
Please choose the type of pad(s) you wish by placing a number inside the Quantity box that corresponds to the desired pad(s). A maximum of 6 pads each can be mailed to you.
Quantity
Pad Type
0
1
2
3
4
5
6
Pain Management (Transdermal/Topical)
0
1
2
3
4
5
6
Pain Management Capsule Therapy
0
1
2
3
4
5
6
Diabetic/Podiatry
0
1
2
3
4
5
6
Wound Care
0
1
2
3
4
5
6
General Practice
0
1
2
3
4
5
6
Women's Health
0
1
2
3
4
5
6
Onocolgy
Your Name:
Address:
City/State/Zip:
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Oregon
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Email:
All fields required
Home
|
About Us
|
Areas of Focus
|
Customer Service
|
Providers
|
Contact Us
866.832.2263 • 251.980.2273
©2009 Compound Care Pharmacy. All Rights Reserved. 30245 County Rd. 49 • Loxley, AL 36551
Site designed and developed by
Pixallure Design LLC
