Rx Scripts and Related Documents Upload Tool

Use this page to securely upload Patient RX Scripts for Faster Processing.

Step 1
Attach Script Image(s)

Select RX Script/Document Image(s) to upload (Max 10 attachments, JPEG, TIF, PNG, PDF formats recommended)

Step 2
Additional Information

Optional contact information to associate with uploaded attachment.
Additional Message to be associated with the Attachment

Step 3
Submit Request

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