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Strive Compounding Pharmacy Β© 2023
E
STRIVE RX
E
Welcome to Strive Rx
E
Hi! What's your full name and role at the clinic?
Sure thing!
π
John
Β ,Β
Doe
E
John
Β ,Β
Doe
π
Doctor
π
john@email.com
π
New Clinic Inquiry Form
BACK
BACK
Title & Email
NEXT
NEXT
E
STRIVE RX
E
Welcome to Strive Rx
E
Hi! What's your full name and role at the clinic?
Sure thing!
π
John
Β ,Β
Doe
E
John
Β ,Β
Doe
π
Doctor
π
john@email.com
π
E
Awesome, thanks! Could we get your clinic's name, website, and information?
Intermountain
π
www.int.com
π
801-889-7898
π
801-889-7000
π
435 S 600 E
π
#606
π
St. George
π
Utah
π
84770
π
New Clinic Inquiry Form
BACK
BACK
Clinic Information
NEXT
NEXT
E
STRIVE RX
E
Welcome to Strive Rx
E
Hi! What's your full name and role at the clinic?
Sure thing!
π
John
Β ,Β
Doe
E
John
Β ,Β
Doe
π
Doctor
π
john@email.com
π
E
Awesome, thanks! Could we get your clinic's name, website, and information?
Intermountain
π
www.int.com
π
801-889-7898
π
801-889-7000
π
435 S 600 E
π
#606
π
St. George
π
Utah
π
84770
π
E
Thank you. We'd love to hear a little more about your clinic to tailor your experience!
John
Β ,Β
Doe
E
Num. of Locations
Β :Β
Doe
π
John
Β ,Β
Doe
E
Num. of Prescribers
Β :Β
Doe
π
AZ, UT, NYC
π
CVS, Target, Walmart
π
New Clinic Inquiry Form
BACK
BACK
Clinic Details
NEXT
NEXT
E
STRIVE RX
E
Welcome to Strive Rx
E
Hi! What's your full name and role at the clinic?
Sure thing!
π
John
Β ,Β
Doe
E
John
Β ,Β
Doe
π
Doctor
π
john@email.com
π
E
Awesome, thanks! Could we get your clinic's name, website, and information?
Intermountain
π
www.int.com
π
801-889-7898
π
801-889-7000
π
435 S 600 E
π
#606
π
St. George
π
Utah
π
84770
π
E
Thank you. We'd love to hear a little more about your clinic to tailor your experience!
John
Β ,Β
Doe
E
Num. of Locations
Β :Β
Doe
π
John
Β ,Β
Doe
E
Num. of Prescribers
Β :Β
Doe
π
AZ, UT, NYC
π
CVS, Target, Walmart
π
E
Which of these medications/services do you offer?
Hormone Replacement Theraphy
π
Peptides
π
Semglutide
π
Other Sterile
π
John
Β ,Β
Doe
E
Are you a national or regional Telehealth Company?
Β :Β
YES
π
John
Β ,Β
Doe
E
Other Products/Services
Β :Β
Are you interested in prescribing Semaglutide?
π
New Clinic Inquiry Form
BACK
BACK
Services and Medications
MEDICATIONS OFFERED?
HORMONE REPLACEMENT THERAPHY
PEPTIDES
SEMAGLUTIDE (GLP-1's)
OTHER STERILE
Extra OFFERINGS
Are you a national or regional Telehealth Company?
NEXT
NEXT
E
STRIVE RX
E
Welcome to Strive Rx
E
Hi! What's your full name and role at the clinic?
Sure thing!
π
John
Β ,Β
Doe
E
John
Β ,Β
Doe
π
Doctor
π
john@email.com
π
E
Awesome, thanks! Could we get your clinic's name, website, and information?
Intermountain
π
www.int.com
π
801-889-7898
π
801-889-7000
π
435 S 600 E
π
#606
π
St. George
π
Utah
π
84770
π
E
Thank you. We'd love to hear a little more about your clinic to tailor your experience!
John
Β ,Β
Doe
E
Num. of Locations
Β :Β
Doe
π
John
Β ,Β
Doe
E
Num. of Prescribers
Β :Β
Doe
π
AZ, UT, NYC
π
CVS, Target, Walmart
π
E
Which of these medications/services do you offer?
Hormone Replacement Theraphy
π
Peptides
π
Semglutide
π
Other Sterile
π
John
Β ,Β
Doe
E
Are you a national or regional Telehealth Company?
Β :Β
YES
π
John
Β ,Β
Doe
E
Other Products/Services
Β :Β
Are you interested in prescribing Semaglutide?
π
E
Let us know a little more about your specific needs!
John
Β ,Β
Doe
E
Are you interested in prescribing GLP-1 Products?
Β :Β
YES
π
John
Β ,Β
Doe
E
Are you interested in prescribing Semaglutide?
Β :Β
YES
π
John
Β ,Β
Doe
E
Minimum number of Semaglutide vials needed per week
Β :Β
YES
π
John
Β ,Β
Doe
E
Minimum number of Semaglutide vials needed per month
Β :Β
YES
π
New Clinic Inquiry Form
BACK
BACK
Please check all that apply (if any)!
Extra OFFERINGS
Are you interested in prescribing GLP-1 Products?
Are you interested in prescribing Semaglutide?
If yes, what is the minimum number of Semaglutide vials needed for your patients?
**At this time, due to high demand, Strive Compounding Pharmacy can only guarantee up to 30 vials per week per clinic.
NEXT
NEXT
E
STRIVE RX
E
Welcome to Strive Rx
E
Hi! What's your full name and role at the clinic?
Sure thing!
π
John
Β ,Β
Doe
E
John
Β ,Β
Doe
π
Doctor
π
john@email.com
π
E
Awesome, thanks! Could we get your clinic's name, website, and information?
Intermountain
π
www.int.com
π
801-889-7898
π
801-889-7000
π
435 S 600 E
π
#606
π
St. George
π
Utah
π
84770
π
E
Thank you. We'd love to hear a little more about your clinic to tailor your experience!
John
Β ,Β
Doe
E
Num. of Locations
Β :Β
Doe
π
John
Β ,Β
Doe
E
Num. of Prescribers
Β :Β
Doe
π
AZ, UT, NYC
π
CVS, Target, Walmart
π
E
Which of these medications/services do you offer?
Hormone Replacement Theraphy
π
Peptides
π
Semglutide
π
Other Sterile
π
John
Β ,Β
Doe
E
Are you a national or regional Telehealth Company?
Β :Β
YES
π
John
Β ,Β
Doe
E
Other Products/Services
Β :Β
Are you interested in prescribing Semaglutide?
π
E
Let us know a little more about your specific needs!
John
Β ,Β
Doe
E
Are you interested in prescribing GLP-1 Products?
Β :Β
YES
π
John
Β ,Β
Doe
E
Are you interested in prescribing Semaglutide?
Β :Β
YES
π
John
Β ,Β
Doe
E
Minimum number of Semaglutide vials needed per week
Β :Β
YES
π
John
Β ,Β
Doe
E
Minimum number of Semaglutide vials needed per month
Β :Β
YES
π
E
Just a few final things. How does your clinic typically write prescriptions, and are you willing to sign up for and use the LifeFile Portal? (It's the breeziest way to get prescriptions filled.) What are your billing preferences?
John
Β ,Β
Doe
E
Preferred Prescribing Method
Β :Β
YES
π
John
Β ,Β
Doe
E
Life Portal Sign up?
Β :Β
YES
π
John
Β ,Β
Doe
E
Preferred Prescribing Method
Β :Β
YES
π
New Clinic Inquiry Form
BACK
BACK
Prescription and Billing Preferences
Select your current prescription method
Select option
Please Select
EMR/EHR
Phone
LifeFile Portal
Fax
Other
EMR/EHR
Interested in the LifeFile Portal?
Select option
Please Select
YES
NO
Select link
Bill your patients or your clinic?
Select option
Select one...
Bill Office
Bill Patient
Select link
** As a 503a pharmacy, Strive Pharmacy only fills patient specific prescriptions and does not dispense in-office stock
SUBMIT INQUIRY
SUBMIT INQUIRY
Thank you,
customer
. Weβre excited to Strive for better together!
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