Rx Order Forms


Download our most compounded forms below:


Please download and print the needed form.

Prescription forms (.pdf) must be filled out and SIGNED BY A PHYSICIAN.


Use one of the method to send us your form:


Email us: rx@zionpharmacy.com

Fax us:     954-839-9039


Anti-Aging, Weight Loss, Erectile Dysfunction, Growth Hormone
Erectile Dysfunction
Sermorelin / Growth Hormone therapy
Dental compounds
Veterinary compounds


Use Credit Card Authorization Form for Recurring Orders:


Credit Card re-authorization form



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Contact Info

Zion Clinic Pharmacy
205 E. Hallandale Beach Blvd
Hallandale Beach, Fl 33009

Phone 954-367-5365
Fax 954-839-9039
Email: info@zionpharmacy.com

Buy Trimix Products

Trimix Autoinjector

Trimix Cool Transporter

Discreet Trimix Carrier

Ultimate Trimix Kit

Penile Band


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