Your Pick-Up Location is: Herbst Compounding, 207 North Dixon Rd., Kokomo.
Please allow our pharmacy a minimum of one hour before pick-up at this location.

NAME*
EMAIL*
PHONE*
ADDRESS
CITY
STATE
ZIP*
Rx #1
Rx #2
Rx #3
(located in upper left corner of label)
please verify that you are human:

What color is the sky?

DELIVERY
METHOD
COMMENT