How to WRite a Valid
 prescription form
The Following Information is Needed for a Prescription:
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Prescriber Info: First Name, Last Name, Address, Phone, and Fax. NPI and DEA.
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Patient Info: First Name, Last Name, Date of Birth, Address (Cannot be a P.O. Box) and Cell Phone Number/Email
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Prescription Information: Drug Name, Strength, Quantity to dispense, Dosage Form, Directions, and Refills.
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Cream Preparations: Indicate the dose and we will calculate the concentration. If this is a compounded formula, that needs to be indicated on the prescription. A statement explaining that the patient requires the compounded product should also be included. We will also need date of issue or prescription signed. Please review the link for more instructions.
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Prescriber Signature: Please include a prescriber signature for all controlled substances. Stamps and electronic signatures faxed in are not considered valid by the DEA.
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Florida, New York, and Iowa now require electronic prescribing for all prescriptions.
how to send in a prescription
More Information
For more information, or to place an order, place call our Customer Service Department at 800.995.4363 or email info@anazaohealth.com