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Partner with BlendRx

Sign up your Medical Clinic to become a BlendRx Compounding Pharmacy provider, and begin filling your patient's prescriptions by mail, delivery or pickup at our pharmacy. After receiving this form, one of our specialists will reach out to your office to get the process started.

3 Step Process:

  1. Fill out the form below.
  2. After submittal, you will receive an email from us with additional information about specific providers at your clinic who will need to prescribe.
  3. If you choose "Bill Office", we will also include a "Clinic Billing Form" in that email.
Clinic Information
CONTACT INFORMATION
I consent to receive SMS text messages from BlendRx. Msg & and data rates may apply. Reply STOP to opt out. By submitting this form and providing your phone number, you give BlendRx permission to text you with important updates or details. If you do not wish to receive SMS campaigns or messages from BlendRx , please do not submit this form.
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