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.