Transfer Your Prescription

To Sheldon’s Express Pharmacy


It’s simple to transfer your prescriptions to us.
Just fill out the information below, and we will take care of the rest!

We will send you a confirmation email when your transfer is complete.



Choose the location you would like to transfer your prescription to:



Name*
Phone*
Street Address*
City*
State*
ZIP*
Date of Birth*
Email*
Comments

Yes, I would like to be contacted by phone
regarding my prescription(s)



Please enter pharmacy information that we will be transferring from below:


1
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
2
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
3
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
4
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
5
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
6
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
7
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name
8
Pharmacy Name
Pharmacy Phone
Prescription #
Drug Name



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  ADD ANOTHER PRESCRIPTION