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prescriptions – Polomar Specialty Pharmacy

Polomar Prescriptions11

At Empower our patients can refill a prescription and our providers may log into either our Office-Use for bulk ordering or Patient-Specific Portals. Purchasing products at Empower Pharmacy can only be done through a qualified healthcare provider. Our products are for prescription-use only and therefore we do not sell directly to any patients or consumers. 

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Prescription Information
Prescriptions and Rx Number*
warning Be sure to include the prescription number, name of medication, dosage
Personal Details
First name*
Last name*
Date of birth*
Email*
Phone number*
Shipping Details
Full address*
City*
State/Province*
Postal/ZIP code*
Prescription Information
Prescriptions and Rx Number*
warning Be sure to include the prescription number, name of medication, dosage
Personal Details
First name*
Last name*
Date of birth*
Email*
Phone number*
Pharmacy Details
Name*
Phone number*
Address*
Prescription Information
Prescriptions and Rx Number*
warning Be sure to include the prescription number, name of medication, dosage
Personal Details
First name*
Last name*
Date of birth*
Email*
Phone number*
Shipping Details
Full address*
City*
State/Province*
Postal/ZIP code*
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