Writing a Prescription

Provider Information

Writing A Prescription for a Compounded Medication

 

Information to Include:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Patient identification (name, date of birth, address) 

2.

Date

3.

Drug allergies

4.

Indicate prescription is to be compounded

5.

Generic name of all active ingredients

6.

Strength or Dose of medication (for example: %, milligram, grams)

7.

Formulation desired (cream, gel, troches, capsule, suppository, ODTs, etc.)

8.

Quantity desired and/or days supply needed

9.

Directions for use

10.

Medical condition being treated

11.

Refills, if any.

If you have any specific questions regarding formulations, do not hesitate to contact our pharmacy.

 

Rose City Pharmacy

903-707-2034

2130 W. Grande Blvd, Tyler, TX 75703

2130 W. Grande Blvd,  Tyler, TX  75703

Monday - Friday: 9AM - 6PM

Saturday: 9AM - 1PM

Sunday: Closed

Tel: 903-707-2034

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