1. PATIENT DETAILS


Would you like to provide your insurance information? (for new clients)


2. CURRENT PHARMACY INFORMATION

Please provide us with some information about the pharmacy where your prescriptions are currently filled.



3. PRESCRIPTION INFORMATION

Please provide us with prescription names and numbers for each of the prescriptions you would like to transfer to Downtown Pharmacy.



Would you like to transfer all of your prescriptions to Downtown Pharmacy?


4. SELECT PICK-UP LOCATION


5. SELECT PICK-UP