Transfer Your Prescription to ConnectRx

Simply fill out the form below. A pharmacist will call you back to gather all the details of your prescription transfer.

"*" indicates required fields

Name*

First Name Last Name

Email*

Phone*

Pharmacy Location*

Free delivery available at both locations

Call Back Time*

Comments

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Thank you!

Thanks for requesting a prescription transfer to ConnectRx. A pharmacist will call you to begin the transfer process. We look forward to serving you!

– The Team at ConnectRx