Prescription Forms

Phone: (818) 649-3859 Fax: (818) 330-9526

Who Can Request it:

Only licensed professionals (MD, NP, PA, RN, or Medical Director) or Med Spas working under a prescriber license are eligible for the free compounded sample.
Our pharmacist will verify credentials and tailor the product based on your specific treatment needs.

How it Works:

Step 1: Submit your prescription form.

Step 2: Pharmacist verifies your license.

Step 3: Confirms the prescription with patient and collects payments.

Step 4: Free delivery within 48 hours or can be picked up at the pharmacy same day.

Prescription Forms

Enhance your treatments. Elevate your brand.

Click on the prescription form to Order Today

Topical Numbing FormCreams, Spray, Lip, & Torche

Anti-Aging/Bleaching FormPreset and Customizeable Formula

Hair Growth FormTopical Foam and Serum Solutions

Chemical Peel FormTopical Solution

Anti-Aging FormPreset and Customizeable Formula

Bleaching Cream FormCream Solutions

Under Eye Lipolyticand Firming Cream

What Our Partners Say

Trusted by luxury medical spas across the country for

our quality, service, and partnership approach.

Sarah Martinez

Owner, Bella Vista Med Spa

"UniMed has transformed our spa's capabilities. Their high quality perfectly matches our brand, and the service is unmatched. Our clients love the results!"

Dr. Rachel Kim

Medical Director, Elite Aesthetics

"The private label options have allowed us to build our own product line. UniMed's support team is incredible, and delivery is always on time."

Michael Johnson

CEO, Platinum Wellness Spa

"Working with UniMed has increased our revenue by 40%. Their flexible pricing and volume discounts make it a win-win partnership."

FAQs

Get Quick Answers to Your Common Pharmacy Questions Here!

Who is eligible to request the free numbing cream sample?

Only licensed medical professionals or Med Spas operating under a licensed prescriber (MD, NP, PA, or RN) are eligible. Our pharmacist will verify credentials before compounding and shipping your sample.

What makes your numbing cream different from over-the-counter options?

Our formula is pharmacist compounded with medical grade active ingredients for deeper, faster, and longer-lasting numbing. It’s tailored for laser, filler, and microneedling procedures — providing superior comfort with minimal irritation.

How long does the numbing effect last?

Typically, the numbing effect begins within 15–20 minutes and can last up to 2 hours, depending on the treatment area and formulation strength. Custom potency options are available during your consultation.

Can I customize the formula for my Med Spa?

Yes! During your pharmacist consultation, we can adjust the ingredient percentage, add secondary agents for faster absorption, or modify the base for sensitive skin or specific procedures.

How long does it take to receive my sample?

Once your license is verified, your compounded sample is prepared and shipped within 1–3 business days. You’ll receive tracking information once it’s on the way.

Is a prescription required?

Yes. Because this is a compounded medication, it must be prescribed by a licensed prescriber. If your Med Spa has a supervising physician or NP/PA on staff, we’ll work directly with them to fulfill your sample request.