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Transfer Prescriptions

  • Transfer your prescription form another pharmacy to AAPEX Pharmacy.
  • Make sure to click the Send button at the end of the form to send the requrest.
Fill in your contact information
First Name
Middle Initial
Last Name
Correo electrónico
Daytime phone
- -
Fill in your contact information
Pharmacy name (Ex. Walgreens 1301 St 16 Ave)
Pharmacy Phone (Include area code)
- -
Rx
Medication Name
1
2
3
4
Automatic Refills in Future:
What is 9 + four ?
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