Medicaid Reorder

A RUSH can be applied at any time and will be shipped in 3-5 business days for a fee. You can find the order confirmation sent via e-mail. View pricing here

Prescription Reorder Form

By law we have to ship Controlled Substance Rx Scripts to an address that does appear on the providers CA Medical and/or DEA license. We also do not ship to P.O. Boxes.

Only the first provider on the script needs to be entered.

Quantity

Add Files: Please attach a copy of your sample in the text bow below. (Optional)

Please specify the changes or special request in the text box below.

Contact Name

Contact Email

Contact Phone

Shipping Address (If Different)

Shipping Method

Rush Order? (Extra fee applies)