Green's Drug Mart - Transfer Your Prescription File

It's easy to transfer. Simply fill out this form and we'll handle the rest.

First Name

Last Name

Date of Birth

Gender

Home Address

Home Phone

Cell Phone

Insurance Information (Provider, Carrier, Version, Client ID)

Name of Your Current Pharmacy

Address of Your Current Pharmacy

Which Green's Drug Mart Location would you like to transfer your prescriptions to?

Primary Care Provider

Medical Conditions

Allergies

Would you like to be set up on automatic prescription refill? (Please speak to a pharmacy team member for more information)

I authorize Green’s Drug Mart to contact my current pharmacy and transfer my prescription and health profile on my behalf

I agree by entering my email, I am consenting to receive occasional correspondence from Green's Drug Mart.