HealthRX.com · Printable question sheet
BPC peptide Oregon pharmacy access questions sheet
Use this sheet before talking with a prescriber, pharmacist or insurer about whether a BPC peptide prescription can be filled in Oregon. Write in the answers and bring the sheet to each visit or call.
Who you are talking with
Write the names as they appear on the label or pharmacy record.
Pharmacy nameName and location of the pharmacy
Prescriber nameDoctor or prescriber who wrote the order
Date of conversationMonth and day of the call or visit
Product as written on the prescriptionName, form and route exactly as written
Bulk source named by the pharmacyManufacturer or supplier, if the pharmacy gives one
Certificate of analysis availableYes or no, and who provided it
Bring or confirm before the visit
Bring copies, not originals, of any printed FDA or Oregon pages.
- Bring the written prescription for the peptide.
- Bring the product name exactly as it appears on any label.
- Confirm the form offered and the route planned.
- Check with the pharmacy whether it compounds from a bulk substance.
- Note any written pharmacy policy it relies on for this product.
- Bring a printed copy of the FDA nominated bulks list page.
- Bring a list of your current medicines and supplements.
Questions to ask the pharmacist or prescriber
- Does this pharmacy compound the BPC peptide under any current FDA policy?
- Which Oregon pharmacy rules does this pharmacy follow for this product?
- Is the bulk substance made by an FDA-registered manufacturer?
- Will you provide the certificate of analysis for this batch?
- How would a serious side effect be reported to FDA MedWatch?
- Does the label state that it is a compounded drug product?
- Would this prescription still be filled if the draft HHS policy is not finalized?
- Who should I contact if the pharmacy declines to fill this prescription?
Conversation record
Write one line for each call, visit or message.
| Date | Person and role | What was said | Follow up needed |
|---|---|---|---|