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*

Free delivery available at both locations

Call Back Time*

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

Thank you!

Thanks for requesting a prescription transfer to ConnectRx. A pharmacist will call you to begin the transfer process. We look forward to serving you!

– The Team at ConnectRx