Where/how did you hear About Merwin's pharmacy?
Tell us about your SCar
What is the scar from?
How old is your scar?
What does your scar look like? Please be very descriptive.
Do any of the following describe your scar?
Where is your scar located?
How large is your scar?
Is your scar painful?
Has your scar been previously treated? (include over-the-counter products, i.e. Mederma)
If yes, please list all therapies:
Who is your practitioner (in case a prescription is needed)?
Practitioner's address (include city, state & zip):
Would you like to receive emails regarding events/promotions? We do not share your information.
Date of Birth