For Prescribers | Order Forms | Two Rivers Pharmacy

Order forms

Download, fill in, fax to 910-748-0245.

One form per category, each carrying every field we need: patient and prescriber details, the full formula with strengths, dosage form, quantity, sig, and refills. Fill it in on screen or by hand.

Low Dose Naltrexone: Precise low-milligram capsules commercial manufacturing does not make. PDF
Hormone Replacement: Creams, troches, and capsules dosed to the patient, not the package. PDF
Pain Management: Topical creams that put the drug where the pain is. PDF
Dermatology: Combination creams, ointments, and solutions in the strength you specify. PDF
Veterinary: Flavored liquids and chews for animals who will not take a tablet. PDF
Men's Health: Injectables, troches, and topicals prepared to your protocol. PDF
Pediatric & Dental: Flavored suspensions and small doses for patients who cannot swallow a pill. PDF

Three routes

However you want to send it.

ROUTE 01

Fax

910-748-0245

The order forms above are built for this. Nothing gets missed and nothing needs a callback.

ROUTE 02

E-prescribe

Two Rivers Pharmacy
101 Broadfoot Ave, Fayetteville NC 28305

Put the full formula in the free text field: every active with its strength, the base, the quantity and the sig. We will read it back to you before we make it.

ROUTE 03

Phone

910-748-0243

If you are not sure what to write, start here. A pharmacist will work the formula out with you and then tell you exactly what to send.

Before you send

What we need on every compound.

On the formula

Every active ingredient with its strength, per dose or as a percentage.
The dosage form: cream, capsule, troche, suspension, gel, chew, injectable.
The base or vehicle, if you have a preference. If not, tell us the site and we will suggest one.
Total quantity, or a days supply and we will calculate it.
A sig that names the amount per dose. Not "apply as directed".
Anything to leave out: a dye, a preservative, gluten, lactose, sugar, alcohol.

On the paperwork

Patient name, date of birth, and weight for any pediatric or veterinary preparation.
For veterinary: species and current weight.
Your NPI, and your DEA number for anything scheduled.
Controlled substances by EPCS or a written prescription. Testosterone is Schedule III.
A phone number we can actually reach you on if something needs a second.

An analytical balance and porcelain mortar on the compounding bench

Send a prescription See the catalog

Questions

What prescribers ask.

My EMR will not let me enter a compound.

Almost none of them will, because there is no NDC to attach. Use the order form and fax it to 910-748-0245, or send a free text prescription and we will confirm the formula with you by phone.

Are you 503A or 503B?

503A. We compound for an individual patient against an individual prescription. We do not manufacture in bulk and we do not sell office stock.

What is your turnaround?

Same day or next for most preparations. If an ingredient has to be sourced we will tell you the day the prescription arrives.

Can you make something that has a commercial equivalent?

Ask us. There are rules about compounding copies of commercially available drugs, and there are recognized clinical reasons that make it appropriate. Document the reason and we will tell you honestly whether we can make it.

Do you ship to my patients?

Anywhere in North Carolina. We are licensed in NC only.

Send a prescription

Send it and we will read it back to you.

Prescriber, patient, or facility. Tell us what you need and a pharmacist will call you back.

Phone910-748-0243

Fax910-748-0245

EmailTwoRiversRx@gmail.com RefillsRefill a prescription online TransferMove your prescriptions to us Visit101 Broadfoot Ave, Fayetteville, NC 28305

E-RxSend to Two Rivers Pharmacy, 101 Broadfoot Ave, Fayetteville NC 28305

HoursMonday to Friday, 9:00am to 5:30pm. Closed Saturday and Sunday.