Email Address

[email protected]

Phone Number

(313) 305-4746

Transfer Your Medications

Prescription Transfer Request Form

Patient Information

Full Name

Email

Phone

Date of Birth

Pharmacy to Transfer From

Pharmacy Name

Phone

Fax

Pharmacy to Transfer To

Pharmacy Name

Phone

Fax

Prescription(s) to Transfer

Patient Signature

Date

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Contact Info

Opening Hours

Monday 9:00 AM - 7:00 PM

Tuesday 9:00 AM - 7:00 PM

Wednesday 9:00 AM - 7:00 PM

Thursday 9:00 AM - 7:00 PM

Friday 9:00 AM - 7:00 PM

Saturday 10:00 AM - 5:00 PM

Sunday Closed