Affordable Medications

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Download Forms


 How to Order
This form describes the ordering process and provides important details you need to be aware of.
 
 Customer Agreement
Please read carefully and sign. This form must be completed before you can register or order medications; however, it only needs to be done once.
 
 Patient Questionnaire
This form tells us about you and helps our pharmacists and doctors to provide patient consultation, as well as to help identify pharmaceutical conflicts.
 
 Order Form
After searching our medication database, use this form to place your order.
 
 Prescription Fax Form
Attach your original prescriptions to this form and fax it in to us. (Remember, after faxing, you must mail us the originals.)
 
 All Forms
Alternatively, you can download everything in one package. This is a large download that may take a few minutes to complete, depending on your internet connection.