Join Our Referral List

Women’s International Pharmacy needs your help. We receive regular inquiries from patients seeking practitioners who understand bioidentical hormone replacement therapy. If this applies to you, please fill out this form to join our practitioner referral list that allows us to offer your contact information to patients seeking help in your area.

Join Our Referral List

  • Agreement

    Please electronically sign below if you agree with the following statement:

    Yes, please include me in your practitioner referral list.

We will provide patients with your accurate contact information, if you have any changes please keep us updated. We are here for you as a resource. Our experienced pharmacists will make your questions and concerns their priority and provide timely feedback. We will make our Educational Resource Center (ERC) available to you and your staff. Our ERC contains extensive information and references on historical, current and innovative solutions for Bioidentical Hormone Replacement Therapy medications. Women’s International Pharmacy will respect your privacy by never releasing your personal information beyond the terms of this process. We will provide you the opportunity to opt out of this list at any time.