Favorites

Thyroid Order Form

Fill out the form below, then click “Submit” when done. Click the SAVE/PRINT button to either save the file to your computer, or to print the document to send a FAX. 

Please enable JavaScript in your browser to complete this form.

THYROID COMPOUND

mcg/
mcg
T3/T4 Check
mcg
T3 Check

CONVERSION OF PORCINE TO COMPOUND EQUIVALENTS

mg dose of porcine
x 0.633 =
T4 dose (mcg)
mg dose of porcine
x 0.15 =
T3 dose (mcg)

Shopping Cart
X
Pharmacy Solutions - RX Compound

Pharmacy Solutions
1921 W Pioneer Pkwy,
Arlington, TX 76013

Pharmacy Solutions - RX Compound

ATTENTION!

YOUR FORM IS NOT SUBMITTED

To submit your order, click the “PRINT/SAVE” button located under this pop-up. 

Print and Save

You can save the PDF to your computer to fax at a later date or print it now to fax immediately.  

Printing Copy Save

Fax your order form to 817-860-6083 for processing.

×
 
Why Choose to Autoship?
  • Automatically re-order your favorite products on your schedule.
  • Easily change the products or shipping date for your upcoming Scheduled Orders.
  • Pause or cancel any time.