Simple Drops Inquiry

Simple Drops Inquiry Form

  • Thank you for your interest in our preservative-free combination glaucoma drops. Fill out the form below to be notified when Simple Drops become available from an ImprimisRx pharmacy. For any further questions, contact us at 844-446-6979.
  • Name
  • Credentials
  • Practice Name
  • Address
  • Phone
  • Email
  • Which formulation(s) are you most interested in?
  • How many glaucoma patients do you typically see per month?
  • *Compounded by a pharmacist pursuant to an individually identified patient. May be customized.