To be completed by a licensed doctor or doctor’s staff only. Please complete this account form to begin prescribing OMNI by OSRX® compounded drops.
Once submitted, we will contact you to discuss our formulations, pricing, prescriber portal, shipping and delivery options in greater detail. Thank you for your interest in OSRX®.
IMPORTANT NOTICE CONCERNING PATIENT PAYMENT RESPONSIBILITY.
If you elect to have us bill your patients directly for their medication, please note the medication will not be shipped to the patient until payment has been fully remitted. We will make reasonable efforts to notify your office if we are unsuccessful in contacting one of your patients for payment.
*Compounded medications are generally not reviewed by the FDA for safety or efficacy. OSRX does not compound copies of commercially available products. References available upon request.
Click here to view potential contraindications.