Licensed Prescribers

You now have the opportunity to start your patient’s therapy using our online referral forms. If you are a licensed prescriber, you can begin the prescription process today.

E-Prescribe

24 Wellness accepts e-prescribing on all medications prescriptions. Using your local 24 Wellness Pharmacy NPI number: 1144845827 under your retail tab in your EMR/HER or standalone e-prescribing application.

Fax

As an alternative for hard copy prescriptions, you can fax your prescription form with a front and back copy of your patient’s benefit card to the pharmacy location on your referral form.

Phone

Call 24 Wellness Rx Pharmacy at (833) 682-3515

Downloadable Referral Forms

Women’s Health

Open Form

Men’s Health

Open Form

Cosmetology/Dermatology Compounding

Open Form

Dental Compounding

Open Form

BHRT Compounding

Open Form

Pain Management 

Open Form

Support

To order customize referral forms for your practice or to request additional information, please (info@24wellnessrx.com) and a representative will contact you directly.