New Prescription

I have a written prescription from my doctor:

  • Please do not use the form below if your doctor has provided you with a written prescription. Your doctor may not authorize a prescription over the phone if he/she has already written one out.
  • If you have a written prescription, please print and fill out this form, and mail it along with your written prescription order(s) to Homescripts Pharmacy to be filled.

I do not have a written prescription from my doctor:

  • Please have your doctor fax your new prescriptions to us at 1-877-396-5970
  • OR  complete the form below if your doctor requests that a pharmacist phone him/her for your new prescription. We will use the information you provide to contact your doctor for authorization to fill your prescription.