HealthRX.com · Printable question sheet
AOD nine six zero four California legal status questions for your prescriber
Use this sheet before a visit or call with a prescriber or pharmacist about whether AOD nine six zero four can be prescribed or compounded in California. Bring it along and write the answers down.
Prescription and pharmacy details
Write these in before you go. Leave a line blank if you do not know the answer yet.
Prescriber name and clinicFull name of the doctor or nurse practitioner
Pharmacy name and phoneThe pharmacy you asked or plan to use
Medicine name as written on any prescriptionCopy the exact wording, including any strength or form
Reason given for the prescriptionWrite the reason in the prescriber's own words
Compounding pharmacy or outsourcing facilityName the facility if one was mentioned
Gather before the visit
Bring copies, not originals, of anything you print.
- Bring the FDA pages on bulk substances and category one no-action policy that the article cites
- Print or bring the FDA safety-risk page that lists AOD nine six zero four in the withdrawn table
- Note whether the prescriber or pharmacy named a bulk substance source or supplier
- Write down any written prescription exactly as you received it
- Check with the pharmacy whether it is state-licensed and how it sources bulk substances
- Bring a list of any other medicines or supplements you already use
- Confirm whether your insurer covers compounded drugs before the visit
Questions to ask
- Is AOD nine six zero four FDA-approved for any use in California?
- Does it appear on FDA's bulk-substance list for state-licensed pharmacies?
- Which FDA condition would allow a California pharmacy to compound it, if any?
- Does the prescriber have a written reason for prescribing it instead of an approved option?
- Will the pharmacy tell me in writing what it is compounding and from which source?
- What human safety information does the prescriber rely on for this medicine?
- Who do I contact if I have a side effect or a question after I start?
Call and visit log
Record each contact so you can show what was said and when.
| Date | Who you spoke to | Answer given | Follow-up needed |
|---|---|---|---|