Naval Hospital Camp Pendleton - Prescription Drop Off Form

This form is to request the processing of a new prescription only, for refills please call 1-866-286-8249. Paper prescriptions will need to be physically brought into the pharmacy to be processed. Your request can take up to 3 hours and you will receive a text once your prescriptions are ready for pick up.

Please note, weekends and federal holiday requests will be processed on the next business day (Monday-Friday 8:00 am- 6:00 pm).

REQUESTS MADE AFTER 1400 (2 PM) MAY NOT BE GUARANTEED FOR SAME DAY SERVICE

Do not input any Protected Health Information (PHI)

Send Prescriptions To:

If you choose a Branch Clinic to pick up your prescription, It will be ready for pick- up the next business day.

Patient's DOD-ID Number

If your DOD ID # is unknown, please enter ten zero's above and a pharmacy tech will reach out to you.

Cell Phone Number

xxx-xxx-xxxx

Cell Service Provider

This allows us to send you a text when your prescriptions are ready for pick up

# of Electronic Scripts (MTF Provider)

# of Electronic Scripts (Network Provider)

List Medications & Additional Comments

list medications here and any additonal comments. (Example: Pregnant or breast feeding, weight of patient *if younger than 12, list of allergies)

Submit

Don't forget to keep your family's information up-to-date in DEERS.

Naval Hospital Camp Pendleton - Prescription Drop Off Form

REQUESTS MADE AFTER 1400 (2 PM) MAY NOT BE GUARANTEED FOR SAME DAY SERVICE

Do not input any Protected Health Information (PHI)

Email Updates

Need to Submit a Claim?

Need Technical Help?

DHA Address

Naval Hospital Camp Pendleton - Prescription Drop Off Form

** REQUESTS MADE AFTER 1400 (2 PM) MAY NOT BE GUARANTEED FOR SAME DAY SERVICE ** ** Do not input any Protected Health Information (PHI) **

Email Updates

Need to Submit a Claim?

Need Technical Help?

DHA Address

REQUESTS MADE AFTER 1400 (2 PM) MAY NOT BE GUARANTEED FOR SAME DAY SERVICE

Do not input any Protected Health Information (PHI)