Medication Request
Visit the form below to make a medication request. For new patients, you will fill out the form as a new patient and provide the requested information and identification.
Currently can prescribed medications to treat erectile dysfunction (Sildenafil/Tadalafil), Premature Ejaculation (Paroxetine), Hair Loss (oral Minoxidil) and HIV Prophylaxis (PrEP/Generic Truvada)
The cost for the provider to review or send the request is $50.
The cost of the medication is something you pay to the pharmacy and it would vary based on your insurance.
No controlled medications, including Testosterone, can be ordered using this form.