Acyclovir Cream w/Aloe Request - Established Client / RxPalace.com

Request for Acyclovir 5% Cream + Hydrocortisone 2.5% with Aloe Vera Prescription, Returning Client

Note: We will only approve this medication for treatment of oral herpes (cold sores) on the lips.

Patients are advised that if after using the medication and symptoms do not improve to seek medical advice from a physician.
Within the United States, this item can only be shipped to Florida residents.

Your Basics

Last Name
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1. MALE
2. FEMALE
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Medical History

Pregnant or Nursing?
What medications are you taking?
List allergies to medications
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For what purpose are you requesting this medication?
How long have you had the condition that you need treatment for?
On what part of the body will you use this medication?
What else are you using to treat your condition?
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