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Prescription Transfers

First Name:
Last Name:
Rx #s and/or name of medication(s):
(Separate each Rx or medication with a comma)
Date of Birth: (MM/DD/YYYY)
Your Address:
Your Phone Number:
Name of Pharmacy Transferring From:
Pharmacy Phone # :
Do you have Insurance? Yes No
If yes, list name of insurance company:
Policy number:
Group number:

 

 

With Carolina Apothecary's Prescription Transfer Form, transferring your prescription
to us has never been easier!

If you have your prescription bottles, locate and fill in your prescription number(s). If you don't have your bottles, just list the names of your medications. Simply fill out your personal information, then list the name and phone number of the pharmacy you're transferring from. If you have insurance, find your insurance card and locate your policy number and group number. After clicking "Submit", your prescription(s) should be ready within 2-3 hours.*

Call 349-8221 to check on the progress of your transfer.


*2-3 hours on average; refill time depends on volume of business and time of day submitted.
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