Write a Compounded Script…

Here’s How:

For a compounded prescription, we need the following information:

• Prescriber Information
  First Name, Last Name, Address, Phone, Fax, NPI and/or DEA

• Patient Information First Name, Last Name, Date of Birth, Allergies and Contact Information (Phone Number and/or Email)

• Complete Prescription
  Please begin with the phrase “Compounded Medication,” followed by the Drug, Dose, Dosage Form, Directions, Quantity, and number of Refills

  • Cream Preparations: We are happy to do the math per application, please just indicate the dose and we will calculate the concentration.

• Prescriber Signature
  Please provide your written signature for all controlled substances
  (NOTE: Stamps and electronic signatures faxed in are not considered valid by the DEA)

By Phone

Call us at 1.435.615.0070 to speak with a pharmacist or leave a voicemail.

By Fax

Send all faxes to 1.435.615.7067. If there is any missing information, we will contact you back via phone or fax asking for specific content.

By Email

Send all emails to info@alpineapothecary.com with the subject line of “Patient Prescription Request [Your Name]”.
If any information is missing, we will let you know.