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.


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.


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.


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

Downloadable Referral Forms

Women’s Health

Men’s Health

Cosmetology/Dermatology Compounding

Dental Compounding

BHRT Compounding

Pain Management 


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