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Vios-Compounding-Female-BHRT-and-OB-Gyn-Form-converted

Vios Compounding Pharmacy provides a full line of compound medications, customized according to your physician's orders.

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Vios-Compounding-Female-BHRT-and-OB-Gyn-Form-converted

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  1. FEMALE BHRT AND OB GYN PRESCRIPTIONFORM 1 OF4 Pleasefaxcompletedformto(800)537-5193orcall(800)518-9831 31035 Schoolcraft Rd • Livonia, Michigan 48150• vioscompounding.com AdditionalDirections ConfidentialityNotice:Thisfaxisintendedforthesoleuseoftheindividualandentitytowhichitisaddressed,andmaycontaininformationthatisproprietary,confidential,privilegedandprohibitedfrombeingdisclosedunder applicable law. If you are not the intended addressee, nor authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone facsimile or any information containedinthefax. If youreceivedthisbymistake,pleasecontactViosat(800)518-9831.

  2. FEMALE BHRT AND OB GYN PRESCRIPTIONFORM 2 OF4 Pleasefaxcompletedformto(800)537-5193orcall(800)518-9831 31035 Schoolcraft Rd • Livonia, Michigan 48150• vioscompounding.com AdditionalDirections ConfidentialityNotice:Thisfaxisintendedforthesoleuseoftheindividualandentitytowhichitisaddressed,andmaycontaininformationthatisproprietary,confidential,privilegedandprohibitedfrombeingdisclosedunder applicable law. If you are not the intended addressee, nor authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone facsimile or any information containedinthefax. If youreceivedthisbymistake,pleasecontactViosat(800)518-9831.

  3. FEMALE BHRT AND OB GYN PRESCRIPTIONFORM 3 OF4 Pleasefaxcompletedformto(800)537-5193orcall(800)518-9831 31035 Schoolcraft Rd • Livonia, Michigan 48150• vioscompounding.com AdditionalDirections ConfidentialityNotice:Thisfaxisintendedforthesoleuseoftheindividualandentitytowhichitisaddressed,andmaycontaininformationthatisproprietary,confidential,privilegedandprohibitedfrombeingdisclosedunder applicable law. If you are not the intended addressee, nor authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone facsimile or any information containedinthefax. If youreceivedthisbymistake,pleasecontactViosat(800)518-9831.

  4. FEMALE BHRT AND OB GYN PRESCRIPTIONFORM 4 OF4 Pleasefaxcompletedformto(800)537-5193orcall(800)518-9831 31035 Schoolcraft Rd • Livonia, Michigan 48150• vioscompounding.com AdditionalDirections ConfidentialityNotice:Thisfaxisintendedforthesoleuseoftheindividualandentitytowhichitisaddressed,andmaycontaininformationthatisproprietary,confidential,privilegedandprohibitedfrombeingdisclosedunder applicable law. If you are not the intended addressee, nor authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone facsimile or any information containedinthefax. If youreceivedthisbymistake,pleasecontactViosat(800)518-9831. Reset AllFields

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