How to Write a Compounded Prescription

Compounded Prescriptions Tailored to Your Patient

Compounding gives providers the flexibility to meet individual medical needs. Our customizable approach to pharmaceuticals allows us to concentrate creams to maximize ease of administration and create oral dosage forms with combinations of active ingredients not available commercially. Patients sensitive to fillers will have options with the potential to accommodate a wide range of allergies.

For a compounded prescription, the following information is required:

  • Patient Info – First Name, Last Name, Date of Birth, Gender, Address, Cell Phone Number, Email, Known Drug Allergies and Patient Identifier (in applicable states – i.e., Driver’s License, SS#, Passport #) and
  • Prescription Information – Date, Drug(s), Dose, Dosage Form, Directions indicating the frequency of use and the route of administration, Quantity, and Refills and
  • Prescriber Information– First Name, Last Name, Practice Address, Phone Number, Fax Number, NPI #, State License Number # and DEA Registration, State Controlled Substance Registration (where applicable).
  • Prescriber Signature – Please provide an authentic pen-to-paper prescriber signature for all controlled substances. Stamps and faxed electronic signatures faxed in are not considered valid by the DEA. Submitting controlled substances via EPCS-certified software is preferable.

How To Send a Prescription

MQRefill App

Download the MQRefill Patient App for fast ordering, refills and


Visit and
click "Refill Request".

Prescription Line​

Call 888.222.2956 and
select option 2.