Rx Scripts and Related Documents Upload Tool
Use this page to securely upload Patient Rx Scripts for Faster Processing.
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Set
Step 1
Attach Script Image(s)
Upload image attachments
Select Rx Script/Document Image(s) to upload (Max 10 attachments, JPEG, TIF, PNG, PDF formats recommended).
Drag & Drop files here
or
Browse
Step 2
Additional Information
Sending Physician Contact Information
Optional contact information to associate with uploaded attachment.
Message
Additional Message to be associated with the Attachment
0/1500
Step 3
Submit Request
You must select at least 1 file to upload.
Complete this Submission
