Become a Provider Partner

Val Vista Pharmacy works with any licensed provider authorized to prescribe medications, including (but not limited to) naturopathic doctors, functional medicine providers, OB/GYNs, hormone specialists, anti-aging practitioners, pediatricians, and veterinarians across Arizona and our licensed states.

Set up your account

Fill out the form below and our team will verify your credentials and activate your account. Once approved, you will have access to our full digital product catalog, Rx order forms, provider education and prescribing guidelines, direct pharmacist consultation line, provider email updates, unique portal login, and more.

Questions before submitting? Call us directly at (480) 887-0244.

Office information

Medical Director *

Office Name *

Office Phone *

Business Address *

City, State, Zip *

AZ License #

DEA #

Delivery details

If you would like your orders delivered, please provide any delivery notes for our courier service, such as the preferred delivery day and time, and where to leave the package (e.g., OK to leave at the front desk):

Yes, I'd like to receive occasional informational emails from Justin at Val Vista Pharmacy with updates, resources, and important pharmacy communications. I agree to the Terms of Service and acknowledge that I have read and understood them.

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Become a Provider Partner

Set up your account

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