WFP New Retail Patient- Herbert's

We are proud to serve all patients, and we are excited to welcome you to the Walberg Family Pharmacies' Family

Free delivery with your medication synchronization

How Our Program Works

We will synchronize your medications to make our free deliveries more convenient for you. We will contact you monthly or every 90 days depending on your fill. Our first call or text will be approximately 7 days prior to your refill date to verify if there have been any changes to your monthly medications. We will then set up convenient and free delivery or in-store pick up if you prefer.

Please fill out the following form and a team member will get in touch with you to finish your set up.

If you have any questions, please call Herbert's Pharmacy at 440-293-6358 from 9am to 7pm EST (Mon-Fri) or 9am to 1pm (Sat or Sun) or stop in to see us.

New Patient Sign Up

Save a trip to the pharmacy with free delivery to your door
Please fill out all information
Name*

First NameLast NameSuffix
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Can Herbert's Pharmacy communicate via text messages to this number?*

YesNo, I prefer a phone call.
Allergies and reactions*
Ex: Penicillin, hives
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name and location of current pharmacy*
Ex: Rite Aid Greenville
Phone Number of current pharmacy*
Please enter a valid phone number.
Best time of day to call you (EST)*

8 am to 12pm1pm to 4pmAfter 4pmAny time
I would like a follow up call from Herbert's Pharmacy*

YesNo, please transfer all of my prescriptions. I will call at least 5 days before I am out of medication.
Are there any prescriptions that you are almost out of and need filled right away?
Ex: I have one week of Atenolol 50mg.
Notes for Herbert's Pharmacy staff.
Signature: I understand that Herbert's Pharmacy will be transferring all of my prescriptions from my current pharmacy. I will contact Herbert's Pharmacy at least 5 days before I am out of medication.*

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New Patient Sign Up