Healthcare Associates
  APPOINTMENTS: 972-258-7499
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PHARMACY

TRANSFER PRESCRIPTION

Many of our new customers have asked how they can transfer their current prescriptions to our conveniently located full-service Pharmacy at Healthcare Associates. Itís as easy as 1, 2, 3!

  1. Simply give the pharmacist your prescription number, name, and telephone number of your current pharmacy.
  2. We call the pharmacy and ask to have your prescription transferred.
  3. And just like that, the prescription is transferred.

We appreciate your business. Our goal is to provide you fast, friendly, expert service for all your pharmacy needs.

Please complete and submit the following application.

First Name:
Last Name:
Phone:
Email:
Date of Birth:
Pharmacy Name:
Pharmacy Phone:  
Prescriptions:
Prescription #:

Prescription #:

Prescription #:

Prescription #:

Prescription #:

Drug Name:

Drug Name:

Drug Name:

Drug Name:

Drug Name:

Last Filled:

Last Filled:

Last Filled:

Last Filled:

Last Filled:

Insurance:
Primary Carrier:

Group #:
Group ID:
Bin #:
 
Secondary Carrier:

Group #:
Group ID:
Bin #:
OUR ADDRESS: 1110 Cottonwood Lane, Suite L100, Irving, TX 75038, Phone 972-258-7499
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