Transfer prescription to Lakeland Pharmacy

Patient Details

Tell us about you so that we can verify who you are with your old pharmacy.

First Name (required)

Last Name (required)

Email Address (required)

Phone Number (required)

Birthday (required)

Previous Pharmacy Info

Tell us about your old pharmacy so we can transfer your medications.

Pharmacy Name (required)

Pharmacy Number (required)

Prescriptions

Transfer all of my medications

- or -

Add the medication name and Rx number for all that you'd like to transfer.

Notes for Pharmacy (Optional)

Verify your insurance here or in the pharmacy when you get your medication.

Questions or Comments

I agree to the terms of services and privacy policy

Input this code: