Patients

Transfer a Prescription

Thank you for choosing College Pharmacy to fill your prescription needs. To transfer a prescription, please fill out all fields in the form below and submit the form to have your prescription transferred. Once your prescription is transferred, we will contact you directly to set-up payment and shipping.

Patient Name:
Address:
Work Phone Number:
Home Phone Number:
Email Address:
Date of Birth:
Pharmacy Name:
Pharmacy Phone Number:
Name of Medication:
Prescription Number:
Name of Doctor:
Quantity:
Date of Last Fill:
Doctor's Phone Number:
Need By:
Additional Comments:
We have several shipping options available. All prescriptions that require refrigeration are shipped overnight on ice through FedEx. We also have additional overnight services available, including early morning delivery in some areas, for an additional charge. Please visit the "Shipping" section of our website for current rates. Your prescriptions are only a phone call away! You may phone, fax, or email your information to us. Please CONTACT US to verify the information and to give us your billing information.