Transfer In Form

Transfer to Good Day Pharmacy

(Fast. Local. Personalized.)
Welcome!

We’re so glad you found us. Transferring to Good Day is simple, effortless, and takes less than 5 minutes. Just complete the form below, and our team will handle everything else—including contacting your old pharmacy and your providers if needed.

Why Thousands of Local Families Choose Good Day
✔ Faster Service – No more waiting days for refills. Most prescriptions are ready same-day or next-day.
✔ Convenient Delivery – Busy? We’ll deliver straight to your home or office.
✔ Personalized Care – We know your name, your story, and your health goals. You’re not a number here—you’re part of the Good Day family.
✔ One Pharmacy, All Your Needs – Prescriptions, custom compounding, women’s health, vaccinations, supplements, and medical supplies all in one place.

What Makes Us Different?
Chain Pharmacies = Long lines, generic care, frustration.
Good Day Pharmacy = Personalized healthcare, built on trust, delivered locally.
- 🩺 Relationships over transactions – your health is not a “check box.”
- 🚗 Local + Independent – rooted in your community, supporting local jobs.
- ✅ Most Insurances Accepted – with cost-saving options like med sync, delivery, and personalized packaging.
Why Transfer Today
1. It’s effortless. We do the work for you.
2. It’s risk-free. If you don’t love us, you can always switch back.
3. It’s better healthcare. You’ll wonder why you didn’t transfer sooner.
“Switching to Good Day was the best decision we made for our family’s healthcare.” – Current Good Day Patient

Ready to Start?

Fill out the quick form below. Our team will be in touch shortly to ensure everything transfers smoothly.

👉 Bonus: Upload a photo of your medication list right on this form—it saves time and gets you started even faster.
Patient Name*

First NameLast Name
Patient Date of Birth*

MonthDayYear
Patient Phone Number*
Please Provide the Best Daytime Phone Number
Patient Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Delivery or Pickup?*

Pickup at PharmacyDelivery ($5 delivery fees may apply)
Patient E-mail*
example@example.com
May we contact you via phone, email or text, to ensure a smooth experience where your needs are met?*

YesNo
Good Day Retail Pharmacy Location*
Which Good Day Pharmacy Location is Closest to you?
Name of Previous Pharmacy*
Please enter your previous pharmacy name.
Previous Pharmacy Phone Number*
We will also call any providers to gain new prescriptions if necessary.
Are you using more than one pharmacy?*

YesNo
Secondary Pharmacy Name*
Please enter your previous pharmacy name.
Secondary Pharmacy Phone Number
We will also call any providers to gain new prescriptions if necessary.
Third Pharmacy Name
Please enter your previous pharmacy name.
Third Pharmacy Phone Number
We will also call any providers to gain new prescriptions if necessary.
Transfer ALL of your medications?*

YesNo
Reason for choosing Good Day Pharmacy (Optional):
Please include any questions or comments.
Save time and take a picture of your medication list

If you cannot take a picture, please type the name of the medications to be transfer:

	Medication Name?	Needed Right Away?
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2
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Transfer the Following Medications:*
Add the Medication Name and Rx Number (if you have it) for all that you like to transfer
How did you hear about us?

Your Provider/PhysicianFacebook/Social MediaGoogle/Online SearchFamily/Friend ($10 Referal Bonus)Business Card QR CodeText MessageRadioNewspaper / PrintPlaza Discount CardOther
Name of the family member or friend who referred you:

First NameLast Name
Provider/Physician Name

First NameLast Name
Please tell us which referral bonus sign you saw!
Ex: Coffee, Refer-a-Friend, Consult Transfer, etc.
Notes for the Good Day Pharmacy Team (Optional):
Please include any questions or comments.
THANK YOU! You’re on your way to experiencing pharmacy the way it was meant to be—fast, personal, and local.

We’ll be in touch soon.

The Good Day Team
GoodDayPharmacy.com
** We will use the information you provide on this form to be in touch with you to provide updates about Good Day Pharmacy via email and text. **
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Transfer to Good Day Pharmacy