Transfer a Prescription

Please complete this form to refill a prescription already on file.

First Name *

Last Name *

Phone *

Email *

Date of birth *

Pharmacy Name *

Pharmacy Phone Number *

Name(s) of Medications Needing Transferred *

Prescription Number(s)

Doctor's Name *

Doctor's Phone Number *

Preferred Delivery Method *

I will pick it up at the pharmacy

Please mail my prescription

Our Sister Locations

Waters Wellness Compounding Pharmacy - Bristol

310 Bluff City Hwy., Bristol, TN 37620

Waters Wellness Compounding Pharmacy - Hickory

750 4th St. SW., Hickory, NC 28602

828-324-4115

Laurel Family Drug Co

204 S Shady Ave, Damascus, VA 24236

919-832-6432

Richlands Pharmacy - Richlands

2625 Front St. Richlands, VA 24641

276-963-2115

Person Street Pharmacy - Raleigh

702 N Person St, Raleigh, NC 27604

919-832-6432

New Garden Pharmacy - Honaker

4697 Redbud Hwy, Honaker, VA 24260

276-873-6132