A) New patients:
Step 1. Obtain a
prescription from your doctor.
Step 2. Print and
complete the following required forms:
|
Important note about
downloading forms:
**Please
right click on the form you want and click on 'save target
as'** |
Download The Complete Order Package:
 Word
Format
 PDF
Format
Step 3.
Fax the prescription, along with the required forms to Rx
Discount at: 1-877-210-3777.
* Please also fax us a copy of your driver's license (or other picture ID).
B) Existing patients
with new prescriptions:
Fax your drug prescriptions along
with the order form to Rx
Discount at
1-877-210-3777.
C)
Existing patients with refill
prescriptions:
Print and
complete the refill order form
and fax it to Rx Discount at 1-877-210-3777.
Refill Order Form:
Word
Format
PDF
Format
If you would prefer that the forms be faxed to you, please
call or email us and we will send them to you.
**PDF Format Forms Require Adobe Acrobat
Reader
Acceptable Methods of Payment:
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