Please fill out this form and fax to 212-233-0444 or email to Pharmacy@DowntownPharmacy.com if you reside in all boroughs except Bronx:


Downtown Manhattan Pre-Pour enrollment form 



Please fill out this form and fax to 718-450-8152 or email to Pharmacy@TowerRx.com if you reside in Bronx



Bronx Pre-Pour enrollment form