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

 


 

Upload your form below:

 

Comments or questions are welcome.

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Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 1mb.

 


 

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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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