Men’s Sexual Health Rx Order Form

Password Notice The following page is exclusive to verified providers, and requires a password from Town & Country Compounding. If you don't have the password yet, get it HERE.

Please Note: This is not access to the provider portal, To access the provider portal click here.

How to send in Prescription Order Forms

Medical practitioners can easily send in their Prescription Order Forms to Town & Country Compounding through our Provider Portal.

Controlled substances must be completed electronically.

Men’s Health & Urology Part I

Compounded Penile Injections (Tri-Mix)
Erectile Dysfunction Treatment Accessories
Libido & Orgasm Aids
Erectile Dysfunction Sublingual Troches
Erectile Dysfunction Capsules / Tablets

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Men’s Health & Urology Part II

Topical Testosterone
Injectable Testosterone
Other Therapy Options
Custom Orders

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