Transfer Prescriptions Online

Transfer Your Prescriptions
Please verify your information below and submit your new prescription transfer request. We will process your request shortly and will contact you if we haveany questions.

Please Note: Zale Drugs will dispense prescription drugs only after receiving a valid prescription in accordance with U.S. federal law.

* Required
 

Your Personal Information

  * First Name: * Last Name:
  Street Address: City:
  * State: Zip Code:
  * Phone: ( )   * Email Address:
      *Date of BIrth:
 

Your Current Pharmacy Information

  * Pharmacy: Pharmacy Contact:
  Street Address: City:
  * State: Zip Code:
  * Phone: ( )   Email Address:
 

Prescriptions Requested

Add up to ten prescritptions at a time.

  QTY RX # Drug Name Strength
1
2
3
4
5
6
7
8
9
10
 
 
 

Special Instructions