About Us
Contact
About Us
Contact
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Indicates required field
Last name
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First Name or Initial
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Phone Number
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Pharmacy Name
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Please enter the name of the pharmacy where your prescription is located.
Pharmacy Phone #
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Please enter the phone number of the pharmacy where your prescription is located.
Please enter the prescription numbers you want to have transferred to Health Smart.
Prescription numbers are usually found in the upper area of the label often preceded by "RX" or "TX".
Pharmacy name and phone number are also found in the upper area of the label.
You may enter up to 6 prescription numbers below. For larger orders please contact us. To have your whole file transferred choose the option below.
1
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2
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3
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4
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5
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6
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Would you like to have your whole file transferred?
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No thanks, only the prescriptions I specified above.
Yes please, I would like all my medications sent to Health Smart pharmacy.
Comments / Special Instructions
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Please Note:
Narcotic prescriptions cannot be transferred, and must be filled at the pharmacy where the original prescription is located. If a narcotic medication is needed please inform your physician you are changing your pharmacy and bring in your new prescription to be filled. Targeted and controlled medications can be transferred one time only.
*For privacy and confidentiality purposes we will give you a quick phone call to verify your request before completing the transfer.
Request Transfer
