Avita Pharmacy can only accept original prescription drug orders from patients.
Faxed prescriptions can be accepted only from the prescribing practitioner.

Patient Enrollment Forms

 Baton Rouge,
Louisiana

 New Orleans | Tulane Tower
Louisiana

New Orleans | Marine Building
Louisiana

 Salisbury,
North Carolina

 Dallas,
Texas

 Houston,
Texas

 San Antonio,
Texas

Florida

Hepatitis C Enrollment Forms

Baton Rouge,
Louisiana

New Orleans,
Louisiana
[all locations]

 Salisbury,
North Carolina

San Antonio,
Texas

 

 

 

 

 

 

 

Dallas,
Texas

Houston,
Texas

Houston | St. Hope

Additional Enrollment Forms

 Lupron Depot Referral Form

Dermatology

Dermatology – Atopic

Rheumatology

Rheumatology – Osteoporosis