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iPharma Patient Upload Center

Fill out the Form below and information will be sent to iPharma Pharmacy Team member

First Name

Last Name

Date of birth

Medication

Tirzepatide 30 mg/Glycine 5 mg/ml - 1 mL

NAD+ 100 mg/ml - 4 mL

Please submit each patient separately.

An email will be sent to the pharmacy team member to create the medical record document requested and then emailed back the designated email address set by MCC managment.

After you click submit, it will have a link to submit another patient.