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VelarisCompounding Pharmacy

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Transfer Prescription

Transfer Your Prescription to Velaris RX

Switching pharmacies is easy. Fill out the form below and we'll handle the rest — including contacting your previous pharmacy on your behalf.

Patient Information

First Name *

Last Name *

Date of Birth *

Phone Number *

Email Address *

Current Pharmacy Information

Current Pharmacy Name *

Pharmacy Phone Number

Pharmacy Address

Prescription Information

Medication Name(s) *

Prescription Number(s)

Prescribing Doctor Name

Doctor Phone Number

Additional Notes

Special instructions or notes

Consent

I authorize Velaris RX Pharmacy to contact my current pharmacy and transfer the prescription(s) listed above. *

I understand that a valid prescription from a licensed prescriber is required for all compounded medications. *

VelarisCompounding Pharmacy

A licensed sterile and non-sterile compounding pharmacy serving the greater Los Angeles community since 1994. Precision compounding, personalized care.

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Services

Sterile Compounding
Hormone Therapy
Pain Management
Veterinary Compounding
Specialty Pharmacy
Non-Sterile Compounding

Contact

16673 Roscoe Blvd, North Hills, CA 91343
(818) 781-2400
Fax: (818) 781-2401
info@velarisrx.com
Mon - Fri: 8:30 AM - 5:00 PM
Sat - Sun: Closed

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