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Welcome to Key Compounding Pharmacy Key Compounding Pharmacy is a nationally licensed and PCAB accredited pharmacy ready to serve you and your with exceptional customer service and provide you with products of the utmost quality. We are a full service compounding pharmacy located in Federal Way, WA just a few miles from the SeaTac airport. Our compounding lab contains the newest and most advanced compounding equipment available in today s market including a state-of-art ISO class 7/8 clean room. Our mission is to empower and healthcare providers to make informed, alternative choices for improved health and wellness via personalized medicine. We specialize in: Bio-identical Hormones Dentistry Manufacturer Shortages Sterile Compounding Vitamin/Amino Acid Blending Chemical Sensitivity Dermatology Pain Management Veterinary Medicine 530 South 336th Street Federal Way, WA 98003 P: 800.878.1322 F: 888.878.1118 www.keycompounding.com

Allergen-Free Compounding We understand that many prescribers face barriers in prescribing due to their allergies and/ or sensitivities to various food and pharmaceutical ingredients. This can impair usability of various manufactured drugs as well as put limitations on compounded drugs. The good news is that we will work with you and your to develop customized medications that suit their dietary and health needs. We can compound medications free of: Gluten Sugar Dairy Dyes Corn Excipients Call our pharmacists today to discuss how we can customize medications.

Family Practice Benefits of Compounding Patient Specific Dosing Alternate Dosage Forms Flavored Medications Gluten, Preservative, Excipient and Dye-Free Formulations Commercial Drug Shortages Inhalation Formulations Sterile Injections Vegetarian Capsules Common Family Practice Formulations Bio-Identical Hormones Progesterone, Estrogens, Testosterone, DHEA Transdermal creams and drops, capsules, oil caps, sublingual drops and troches, vaginal creams Dermatological Formulations Acne Ascorbic Acid Gel Azelaic Acid Gel or Cream Niacinamide Gel or Cream Azelaic Acid/Niacinamide Gel or Cream Face Creams (see Facial Care Flyer) Elastic Skin Cream PG Formula Face Lotion #1 Face Lotion #2 Face Lotion Fantastic Diabetic Care Diabetic Ulcer Cream Ketoprofen, Lidocaine, Misoprostol, Phenytoin Topical Neuropathy Creams Foot Care Nail Anti-Fungal Solutions Terbinafine/Itraconazole /DMSO Pain Creams Neuropathic Pain Creams Hypo/hyperthyroidism Patients specific blends of T3 and T4

Oral Care Oral rinses Magic mouthwash Diphenhydramine/Lidocaine/Nystatin/Glutamine Sore Throat Tetracaine Lollipops Ulcers Polyox bandages Viral Cold Sores Acyclovir 2%/ Deoxy-D-glucose 0.2% Miscellanous Formulations Boric Acid Suppositories - Recurrent vaginitis Vaginal Creams - Estriol 0.05%/Testosterone 0.05% Hemorrhoid Suppositories Rectal Rocket Anal Fissures Suppositories, creams Butt Paste-Coloderm II/Urea/ Bacitracin/Neomycin/Triamcinolone Numbing Cream/Gel Benzocaine/Lidocaine/Tetracaine (BLT) Lidocaine/Epinephrine/Tetracaine (LET) Pediatric Formulations Diaper Rash Cholestyramine 5% in Aquaphor Oral Suspensions Respiratory Care Antifungal Nasal Sprays Glutathione Hydroxocobalamin Sexual Dysfunction Libido Formulations Aminophylline 3%/Arginine HCl 6% Topical Cream Oxytocin (Nasal spray/troches) Erectile Dysfunction Trimix Injection Sildenafil Troches Topical Pain Creams NSAID s Ketoprofen/Piroxicam Neuropathic creams Can contain any medications such as Gabapentin, Amitriptyline, Ketamine, Ketoprofen, Piroxicam, Clonidine Shingles Gel Muscle Spasms DMSO/Magnesium Chloride/Emu Oil Lotion Key Compounding Pharmacy is proud to be Washington State s first PCAB accredited pharmacy. PCAB Accreditation is recommended by the American Medical Association. 1 1. http://www.ama-assn.org/ad-com/polfind/hlth-ethics.pdf; p.96

530 South 336 th Street Federal Way, WA 98003 (800) 878-1322 Fax (888) 878-1118 New Provider Intake Form We are not licensed and therefore cannot provide service to in: AR, CO, KY, LA, NC, NE and TN. Provider Information Provider Name New Prescriber Title MD DO ND DDS DPM ARNP DVM Other Provider Exp State License # Date Licensed NPI DEA Exp Date Practice Information Practice Name Specialty Address Ste City State Zip Phone Fax Website Email Do you currently use a compounding pharmacy? Yes No How did you hear about us? IFM Hormone & Detox July 2014 (Code 0711) IFM AFMCP Sept 2014 (Code 0908) IVNTP Sept 2014 (Code 0927) WANP Oct 2014 (Code 1011 Other Completed intake forms should returned to: Key Compounding Pharmacy Patient & Provider Relations Fax (888) 878-1118 or Email: ppr@keycompounding.com FOR OFFICE USE ONLY Entered into PK? Yes No Board Actions? Yes No If yes, attach info Cleared? Yes No Initials Date New Provider Intake Form 7-14