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Prescription Transfer Request

If you have been getting prescriptions filled at another pharmacy we are glad to transfer your prescriptions to our pharmacy. We can do this even if they are currently located out-of-state.

What to do:

Just fill out the following form, print it off, and do one of the following:

DROP OFF:
or FAX:

Once we receive the information we will contact your pharmacy and transfer the prescription here, fill it, and have it ready for you when you come to pick it up. The whole process usually takes less than 30 minutes.

Name:
Date of Birth:
Prescription # (located on your prescription label, usually the upper left hand corner):
Name of Medication:
Pharmacy Name:
Pharmacy Phone #:
Your Cell Phone Number:

*NOTE: If you have more than one prescription you need transferred, please fill out a form for each medication or just call us at 496-9342 and we'll take of the rest!

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