LET'S GET ORGANIZED

TAKING YOUR MEDICATION JUST GOT A LOT EASIER.

Our pharmacists put all your morning medicines in one pack, evening medicines in one pack. Simply open and take. All the work done for you. We call the doctor for refills. All you do is fill out this form.

SIGN ME UP!

Free Text

It takes approximately one week for us to set you up for our med packs. Please keep 7 days worth of medications at home and bring us any extra medicine you have on hand. We don't waste medicine!

Name:

Address:

Email:

Phone:

home

mobile

work

Date of birth:

Current pharmacy

Current pharmacy phone number:

Drug allergies

Pick up or delivery?

Pickup at the store

Deliver it to me

Does someone help you manage your medications?

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Medicine 1

Medicine 2

Medicine 3

Medicine 4

Medicine 5

Medicine 6

Medicine 7

Other medicines

By checking this box, I acknowledge that I will let my pharmacist know if my doctor changes my medicine regimen or discontinues a medicine.

Medical Pharmacy

LET'S GET ORGANIZED

TAKING YOUR MEDICATION JUST GOT A LOT EASIER.

SIGN ME UP!