Have a new prescription to fill?
Whether you are a new or returning patient, uploading your prescription is quick and easy. Use the secure form below to submit your prescription from your provider.
Frequently Asked Questions
Both new and existing patients can use this form. If you are a new patient, you will provide your personal and contact details when you fill out the form. If you are an existing patient, simply use the name, date of birth, and cell phone number already on file.
You will need:
Your full legal name and date of birth
Your mailing address and phone number
Your prescribing doctor's name and contact information
A clear photo or scan of your written prescription
Yes. Doctors can e-Prescribe, call or fax a prescription directly to the pharmacy. If your doctor sends the prescription directly, you may still complete the patient information section of this form so we have your contact details on file.
The form accepts JPG, PNG, and PDF files. A clear photo taken with your phone is acceptable. Make sure the full prescription is visible, including your doctor's signature and DEA number, if applicable.
A pharmacist will review your prescription and contact you, usually within one to two business days, with pricing details, expected turnaround time, and any follow-up questions.
Yes. Existing patients can use this same form to submit a new prescription to continue refills after their previous prescription on file has no refills remaining or has expired. Your doctor must authorize the refill before it can be prepared.
Questions? We're here to help.
Our Customer Care Specialists and Pharmacists are standing by to guide you. Give us a call or send an email by clicking the buttons below.