Compounded Prescription Order Form - GD Compounding Pharmacy 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your full name in the designated field. If you are an existing customer, select 'YES' or 'NO' accordingly.
3. Fill in your address and daytime contact phone number to ensure accurate communication.
4. If applicable, provide your Private Health Fund details and Concession Card Number.
5. In the 'Special Instructions' section, include any specific requests or notes regarding your prescription.
6. Indicate the total number of items ordered and select your preferred flavor from the provided options for troches or sublingual drops.
7. Choose a collection method by ticking the appropriate box for your preferred location and specifying a time if necessary.
8. Finally, review all entered information for accuracy before submitting. You can fax or email this completed order form along with your original prescription as instructed.

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