# | Order ID | Form | Name of Customer | Address | Status |
---|---|---|---|---|---|
1 |
238b8572f5d0e1f8aa50b1b3859008bb1726673478
09/18/2024 11:36 |
theurbanyou.com | Kerry Siereveld | 2425 87th st Byron center, MI - 49315 | For Doctor's Approval |
2 |
b041a0518d1bfd3dd21802768e737a9b1726413716
09/15/2024 11:25 |
theurbanyou.com | Nicole Gregory | 5431 EGYPT CREEK BLVD ADA, MI - 49301 | Completed |
3 |
fe8ca0e3c1cf143b9195cef36fd13a571726340528
09/14/2024 03:07 |
gomymeds.com | Carole Israel | 9070 Tracy Court Aot. 2 Boca Raton, FL - 33496 | Completed |
4 |
106bde6095af9fec89253c0cd3743ff81725730936
09/07/2024 01:42 |
thinnex.com | Test test | 4705 S Adelle Cir Mesa, AZ - 85212 | For Doctor's Approval |
5 |
106bde6095af9fec89253c0cd3743ff81725574622
09/05/2024 06:17 |
thinnex.com | Test Test | 123 Example Mesa, AZ - 85212 | For Doctor's Approval |
6 |
73aec2710eec63b5dcf2ebf2ce05b1f51725396254
09/03/2024 04:46 |
gomymeds.com | Jennifer Krup | 890 broadway Woodmere, NY - 11598 | Completed |
7 |
1725360477
09/03/2024 06:49 |
trimapill.com | JAY R MAGDALUYO TRIMAPILL | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
8 |
48dd37d446b3de83757c8aa3d4fa087f1725149511
08/31/2024 08:22 |
body4ever.com | Melinda Carroll | 2505 E. Mountain Dr. Gilbert, AZ - 85297 | Completed |
9 |
3cf62a547f12b014d067428f49b418931724810979
08/27/2024 10:11 |
gardenia-rx.com | JAY R MAGDALUYO TEST GARDENIA | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
10 |
e67687cd07ddc608a89dc0433fbeb3f41724773663
08/27/2024 11:52 |
gardenia-rx.com | test test | 18000 portofino circle Palm Beach Gardens, FL - 33418 | For Doctor's Approval |
# | Order ID | Form | Name of Customer | Address | Status |
---|---|---|---|---|---|
1 |
238b8572f5d0e1f8aa50b1b3859008bb1726673478
09/18/2024 11:36 |
theurbanyou.com | Kerry Siereveld | 2425 87th st Byron center, MI - 49315 | For Doctor's Approval |
2 |
106bde6095af9fec89253c0cd3743ff81725730936
09/07/2024 01:42 |
thinnex.com | Test test | 4705 S Adelle Cir Mesa, AZ - 85212 | For Doctor's Approval |
3 |
106bde6095af9fec89253c0cd3743ff81725574622
09/05/2024 06:17 |
thinnex.com | Test Test | 123 Example Mesa, AZ - 85212 | For Doctor's Approval |
4 |
1725360477
09/03/2024 06:49 |
trimapill.com | JAY R MAGDALUYO TRIMAPILL | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
5 |
3cf62a547f12b014d067428f49b418931724810979
08/27/2024 10:11 |
gardenia-rx.com | JAY R MAGDALUYO TEST GARDENIA | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
6 |
e67687cd07ddc608a89dc0433fbeb3f41724773663
08/27/2024 11:52 |
gardenia-rx.com | test test | 18000 portofino circle Palm Beach Gardens, FL - 33418 | For Doctor's Approval |
7 |
2de728e99e2b5d5bfddff2284b971c321724082584
08/19/2024 11:50 |
thinnex.com | Dimitry Prophete | 1800 North Field Street Building 1, Unit 3509 Dallas, TX - 75202 | For Doctor's Approval |
8 |
f3bdd86afcee763cd780d4a6e60a87451724005337
08/18/2024 02:23 |
theurbanyou.com | Test Test | 1309 Coffeen Avenue STE 1200 Sheridan, WY - 82801 | For Doctor's Approval |
9 |
45f960efb036ae246bf2ee56fee929c91724004869
08/18/2024 02:15 |
theurbanyou.com | test Test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
10 |
3d88e6e46a76a0944a1b2297d9cf558f1724003148
08/18/2024 01:46 |
https://www.alexandriacompounding.com/ | test Test | 1309 Coffeen Avenue STE 4070 MESA, AZ - 85212 | For Doctor's Approval |
11 |
832cc51d6ea014b22cdb359f714e87b01723578691
08/13/2024 03:52 |
gardenia-rx.com | TEST TEST | 18000 PORTOFINO CIRCLE palm beach gardens, FL - 33418 | For Doctor's Approval |
12 |
832cc51d6ea014b22cdb359f714e87b01723575319
08/13/2024 03:03 |
gardenia-rx.com | TEST TEST | 18000 PORTOFINO CIRCLE palm beach gardens, FL - 33418 | For Doctor's Approval |
13 |
b108417c38155222bf0d14cbb48c71231723483272
08/12/2024 01:21 |
thinnex.com | Test Test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
14 |
b108417c38155222bf0d14cbb48c71231723482106
08/12/2024 01:02 |
thinnex.com | Test test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
15 |
b108417c38155222bf0d14cbb48c71231723090715
08/08/2024 12:19 |
thinnex.com | Test Patient | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
16 |
b108417c38155222bf0d14cbb48c71231723090563
08/08/2024 12:16 |
thinnex.com | test two | 1234 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
17 |
cf2c38b45180395899862828f5560ac31723090099
08/08/2024 12:10 |
thinnex.com | test test | 4705 S Adelle Cir Mesa, AZ - 85212 | For Doctor's Approval |
18 |
0398b4821e075b96bcd5918b00eb43e81723087776
08/07/2024 11:30 |
thinnex.com | Test Test Thinnex | Test Test Test, AK - Test | For Doctor's Approval |
19 |
b108417c38155222bf0d14cbb48c71231723057327
08/07/2024 03:03 |
thinnex.com | Test Test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
20 |
b108417c38155222bf0d14cbb48c71231723057194
08/07/2024 03:00 |
thinnex.com | test test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
21 |
0398b4821e075b96bcd5918b00eb43e81722916996
08/06/2024 12:06 |
thinnex.com | jayr test thinnex 2 | Test Test test, AK - 5611 | For Doctor's Approval |
22 |
fdbdaa9540999c52cae899416d1898da1722911144
08/05/2024 10:27 |
thinnex.com | JAY R MAGDALUYO THINNEX TEST | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
23 |
8667104ab377e9242570a7e77acac8381722358007
07/30/2024 12:47 |
DemoAcccount.com | test test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
24 |
0052212b096a02f3b2be3c63853142ff1722348260
07/30/2024 10:05 |
Thinnex.com | Test Test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
25 |
0052212b096a02f3b2be3c63853142ff1722347273
07/30/2024 09:49 |
Thinnex.com | Test Test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
26 |
3e9c4e28e7f297a37545f21566620fa71722332363
07/30/2024 05:41 |
gardenia-rx.com | JAY R TEST AUTH 1 | 6M CLUSTER 31 CAMBRIDGE VILLAGE, BRGY. SAN ANDRES CAINTA, RIZAL, AK - 1800 | For Doctor's Approval |
27 |
1721736923
07/23/2024 08:16 |
body4ever.com | Test Test | 4705 S Adelle Circle Mesa, AZ - 85212 | For Doctor's Approval |
28 |
b05dc90125b268f1f8ba8edb5168ad221720838753
07/12/2024 10:46 |
gomymeds.com | Test test | 4705 S adelle circle MESA, AZ - 85212 | For Doctor's Approval |
29 |
1720543680
07/09/2024 12:51 |
body4ever.com | Amy Bjork | 133 Pineneedle Dr Bradenton, FL - 34210 | For Doctor's Approval |
30 |
f77342dc801ace6aad122bd5c653b1f61719966509
07/02/2024 08:32 |
gomymeds.com | Daniel Bonder | 2721 NE 8th terrace Pompano beach, FL - 33064 | For Doctor's Approval |
31 |
c1e031fd98f3273073a7155e35524fbb1719349398
06/25/2024 05:04 |
nrish.com | TEST TEST | 2813 N 29TH PL Phoenix, AZ - 85008 | For Doctor's Approval |
32 |
64e6b757ed758cb3e00e6ad75f75d8501718309281
06/13/2024 04:08 |
DemoAcccount.com | test test | 116 w geneva dr tempe, AZ - 85281 | For Doctor's Approval |
# | Products | SKU | Title | Qty | Price |
---|
Patient Name (First, Last) |
SEX |
|
||||
DOB | Cell Phone | |||||
Address |
Required Patient Information (Fill out or attach demographics with fax) | |
Allergies (if none, must write none) |
|
Current Medications (if none, must write none) |
|
Driver’s License # |
|
|
|
Facility Name | Facility Phone | ||
Facility Address |
* If Provider is a NP/PA a Supervising Provider is required for a Controlled Substance (or a Standing Order must be on file) *
Doctor Name Goes Here | |
---|---|
Docotors' Notes Content Here | Edit |
# | Order # | Card No. | Amount | Invoice | Invoice Created |
Is Paid | Is Refunded |
---|
# | Order # | Prescription Order No. |
Name | Medication | Refill No | Days Supply | Refills | Order Status |
Canceled At |
Tracking No. |
Shipping Provider |
Date Delivered |
---|
Patient Name (First, Last) |
SEX |
|
||||
DOB | Cell Phone | |||||
Address |
Required Patient Information (Fill out or attach demographics with fax) | |
Allergies (if none, must write none) |
|
Current Medications (if none, must write none) |
|
Driver’s License # |
|
|
|
Facility Name | Facility Phone | ||
Facility Address |
* If Provider is a NP/PA a Supervising Provider is required for a Controlled Substance (or a Standing Order must be on file) *