HealthRX.com · Printable question sheet
CJC-twelve ninety-five access and legality questions
Use this sheet before a visit with a prescriber, pharmacist or insurer when you are asking whether CJC analogue products can be obtained legally in Florida. Fill in the product details and bring it along.
Product details I found
Copy these exactly from the seller, label or invoice. Do not add your own reading of them.
Seller or source nameWrite the name as it appears on the site, clinic or label
Product name on the labelCopy the wording exactly
Label wording about useFor example research use only or similar words
Form and strength statedCopy as written, do not calculate
Date I found this product
Who I was told would prescribe it
Gather before the visit
Bring these so the conversation can stay on the records.
- Bring a printed copy of the article and its referenced FDA lists
- Bring any label, invoice or order confirmation for the product
- Write down the state pharmacy rules you have already looked up
- List every medicine and supplement you currently take
- Note whether the seller asked for a prescription or a health history
- Check with your pharmacist which state licensing board covers your pharmacy
- Note any health conditions your prescriber should know about
Questions to ask
- Is this product approved by the FDA for any use in the United States?
- Is this product on the state pharmacy bulk substances list?
- Does Florida law allow a pharmacy in Florida to prepare this product on a prescription?
- Which Florida board or agency should I contact to confirm the rules for this product?
- Would you prescribe this product to me, and if so under what written record?
- Does my health insurance cover any product in this group, and what proof do you need?
- Is this product on any sports list that applies to me, such as a drug testing program?
- What reports exist about side effects from this product, and where can I read them?
Calls and visits record
Write one line for each contact. Note the answer in the person's own words.
| Date | Person asked | Answer given |
|---|---|---|