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Available Forms

Drug Shortage Request Form

Drug Shortage Request Form - Plaquenil (Hydroxychloroquine Sulfate)

Patients taking Plaquenil® (Hydroxychloroquine Sulfate) may be having a hard time finding their maintenance medication due to increased demand from the coronavirus pandemic. Our pharmacy staff specializes in preparing medications from scratch using a state-of-the-art compounding lab.


Medication Details

Medication strength and directions

Health Care Provider Information

A prescription from a licensed provider is required for compounded medications.

* Required field