Organization's Primary Location: —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Which States Do You Serve? All 50 StatesALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Company Size: —Please choose an option—1-10 employees10-100 employees100-500 employees500-1000 employees1000+ employees
Which Therapeutic Classes Are You Interested In? Men’s HealthWomen’s HealthWeight LossDermatologyHRTMental HealthAnti-AgingColon-RectalSupplementsPet Medications
Bremelanotide (PT - 141) Nasal SpraysSildenafil Sublingual TabletsTadalafil Sublingual TabletsSermorelin 2mg / mL VialsOther
Boric Acid SuppositoriesBoric Acid / Metronidazole / Lactobacillus SuppositoriesBoric Acid / Clotrimazole / Hydrocortisone / Lactobacillus SuppositoriesBoric Acid / Lactobacillus SuppositoriesBoric Acid / Hydrocortisone / Lactobacillus SuppositoriesClindamycin / Nystatin / Vitamin E SuppositoriesClindamycin / Vitamin E SuppositoriesClotrimazole / Boric Acid / Acidophilus Lactobacillus SuppositoriesMetronidazole / Clindamycin SuppositoriesMetronidazole / Clindamycin / Nystatin SuppositoriesMetronidazole / Nystatin SuppositoriesMetronidazole / Clindamycin/ Hydrocortisone / Nystatin SuppositoriesDiazepam SuppositoriesAcyclovir OintmentsHyaluronic Acid / Vitamin A / Aloe + Vitamin E CreamsLidocaine / Amitripryline CreamsNystatin / Ascorbic Acid CreamsSildenafil / Pentoxifylline / Ergoloid Mesylates CreamsJack-Newman's All Purpose Nipple Creams (Betamethasone / Mupirocin / Ointment Miconazole)Other
Naltrexone / B6 / Bupropion (Slow Release) CapsulesLiraglutide 6mg Methionine 2mg/mL Injection Solution VialsMICM: Methionine 15mg Inositol 50mg Choline Chloride 100mg Methylcobalamin 1mg/mL MDV VialsOther
Low Dose Minoxidil CapsulesClindamycin / Tretinoin / Niacinamide CreamsFluocinoline Acetonide / Hydroquinone / Tretinoin Acid CreamsHydroquinone / Ascorbic Acid / Niacinamide CreamsHydroquinone CreamsHydroquinone / Tretinoin / Hydrocortisone CreamsMinoxidil SolutionsFinasteride / Minoxidil SolutionsFinasteride / Minoxidil / Progesterone / Fluocinonide SolutionsMinoxidil / Finasteride SolutionsOther
Anastrozole TabletsClomiphene Citrate TabletsDHEA / Pregnenolone (Immediate Release / Slow Release) CapsulesEnclomiphene Citrate CapsulesEstradiol CapsulesProgesterone (Slow Release) CapsulesProgesterone IR (Compounded) CapsulesOxytocin Nasal SpraysProgesterone SuppositoriesEstriol CreamsEstriol / Testosterone CreamsProgesterone CreamsTestosterone CreamsOxytocin TrochesTestosterone Sublingual TabletsNandrolone 200mg/mL VialsTestosterone Cypionate (Grapeseed Oil) 50mg / ml VialsTestosterone Cypionate (Grapeseed Oil) 200mg / ml VialsTestosterone Cypionate (Grapeseed Oil) 200mg / ml VialsOther
Ketamine SuppositoriesKetamine RDTsKetamine TrochesKetamine Nasal SpraysOther
NAD+ Nasal SpraysNAD+ Face CreamsTretinoin / Azaleic Acid / Niacinamide CreamsOther
Diazepam SuppositoriesDiltiazem HCL OintmentsDiltiazem HCL / Lidocaine HCL OintmentsDiltiazem HCL / Lidocaine HCL / Hydrocortisone AC OintmentsNifedipine CreamsNifedipine / Lidocaine HCL CreamsNifedipine / Lidocaine / Petrolaum CreamsNitroglycerin CreamsOther
SKU 1SKU 2
Projected Volume: —Please choose an option—Pre-Launch / less than 250 per month250-500 per month500-1000 per month1000-2000 per month2000-5000 per month5000-10000 per month10000+ per month
Have you contracted with a Telehealth Provider Network? If yes, which Provider Network? YesNo
If you are not using a Telehealth Provider Network, which EMR are you using?
Are you able to trigger electronic prescriptions through your e-prescribing platform? YesNo
Do you have a software development team? YesNo
To work with Precision, it is required that your software system has API and webhook capabilities. Is your system able to support these functions? YesNo
What type of consumer marketing do you leverage?
What is your expected monthly marketing budget?
Are you LegitScript certified? YesNo
Are you offering compounded products, commercial products or both? Compounded ProductsCommercial ProductsBoth
Will you be sending sterile or non-sterile presctipions? SterileNon-SterileBoth
Are you interested in sending controlled substance prescriptions? YesNo
Are you interested in sending OTCs or supplements? YesNo
How Did You Hear About Precision Compounding Pharmacy? —Please choose an option—Internet SearchSocial Media (LinkedIn, Etc...)News Source, Publication, Blog, or ConferenceRecommended by Friend/ColleagueOther
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