Portal Questions/Feedback
I am a:
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Pharmacy
Prescriber/Clinic
Other (specify)
Pharmacy/Clinic Name
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
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example@example.com
How can we assist?
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Submit a general question or feedback
Request a custom portal for my clinic or pharmacy
Report a shipping issue (delay, damaged shipment)
Billing/invoicing question
Something else:
Pharmacies: Which features would you like to see in your portal?
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Easy access to Hawthorne Compounding Pharmacy resources
View/update my pharmacy's account information
Access to shared documents (contracts, invoices, etc)
Track my shipments from Hawthorne Compounding
Reporting dashboard and schedule reports
Others (specify):
Prescribers: Which features would you like to see in your portal?
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Easy access to Hawthorne Compounding Pharmacy resources
Request custom prescribing forms (non-control meds only)
View/update my clinic's account information
Access to shared documents (contracts, invoices, etc)
Track my shipments from Hawthorne Compounding
Reporting dashboard and schedule reports
Bill/Invoice #
Issue type
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Shipment was damaged (e.g. broken, leaking)
Temp tags
Shipment lost/never received
Label or documentation error
Wrong or missing item
Something else:
Tell us more about your request:
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Submit
Should be Empty: