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) **