ORDER FORMS

FORM FOR NEW ORDERS:
Download the AmeriPharm order form Acrobat PDF file here.

• If this is your first order, please read and sign the privacy policy statement form and include with your order.

FORM FOR PRESCRIPTION REFILLS:
ONLINE REFILL ORDER FORM

NEED YOUR PRESCRIPTION RIGHT AWAY?
1. Ask your doctor to write two prescriptions. One for a 30-day supply, and one for a 90-day supply (when appropriate).

2. Take the first prescription to your local pharmacy and have it filled immediately.

3. Send the second prescription to us, using the steps outlined in the AmeriPharm order form Acrobat PDF file. Your AmeriPharm order will arrive within 14 days from the date you mail it. You may then order your refills online!

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