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Patient Information Sheets
Please click on the links below to view the digital version of the patient information sheets. Would you like to request office materials for your office? Please click here to fill out the form, and we will ship them directly to you.
LessDrops Drop Schedule Sheet
This interactive PDF will allow you to personalize your patient’s drop therapy schedule, simply select the appropriate information from the drop down menus or check boxes and print it out.
Do you have an electronic medical record (EMR) system? If so, please download one of the following EMR instruction cards which will help you send a prescription directly to our pharmacy. If you have any questions, please email our EMR expert at firstname.lastname@example.org.
Please download one of the following forms to order by faxing in a prescription. You may complete it and fax it directly to the number on the form. Our pharmacy will process your order within 72 hours, and send to you via the shipping method chosen.
Compounded formulations typically prescribed in the following categories:
Ophthalmic Patient Specific Order Forms
- GoDropless®Order Form
- LessDrops® Topical Order Form
- Mydriatic 3 & 4, Atropine Order Form
- IV Free® Order Form
- Simple Drops® Order Form
- Total Tears®Order Form
- Integrative Injectable Order Form
Please note: If faxed, the prescription must be sent in by a prescribing practitioner to be considered.