Transfer Your Prescription to ConnectRx

Simply fill out the form below. A pharmacist will call you back to gather all the details of your prescription transfer.

"*" indicates required fields

Name*

First Name Last Name

Email*

Phone*

Pharmacy Location*

Call Back Date*

Call Back Time*

This field is for validation purposes and should be left unchanged.

(518) 273-1402
Transfer Prescription
Refill a prescription Log in to LocalRx to securely submit your refill request!
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