NEW Rx Submit .:. Upload
PLEASE NOTE: We do not fill prescriptions for any provider, written by that provider. It might be legal, but it is not something I do. WE ALSO DO NOT COMPOUND GLP1 OR BIOLOGICS. Ever.
All prescriptions submitted by anyone other than the provider (or representative of the provider) will be verified with the provider signing the prescription prior to filling.
Please do not attempt to commit fraud.
Provider's Name
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Provider First Name
Provider Last Name
Prescription Submitter's Email
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legalprovider@legalprovider.com
Provider License Number, NPI, or DEA #.
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DEA Number required for controlled substances.
Provider Title
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MD, DO, FNP, RN, APRN, DVM, DDS, etc.
Upload Signed Prescriptions Here
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of
Special notes or Valid Medical Rationale* (*for veterinary patients):
Leave blank if none.
Patient phone number (if not included on RX document):
If there's no phone number, we have no one to call.... *sniff*
Doctor's Signature
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Please verify that you are human. Then wave at the screen joyfully.
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