Super easy
Super convenient
Transfer your prescriptions to Evergreen
Pharmacy to receive
  • Greater cost savings
  • Quality pharmaceutical
  • Fast service
We can easily transfer your existing
prescriptions from another pharmacy.  
Submit your prescription transfer request
and we will take care of the rest.

If you would prefer to give this information
over the phone, do not hesitate to call us or
stop by with your prescription bottles.  We
can get the information we need to fill your

Prescription transfers will be processed
during normal business hours (9am to 6pm)
and are usually ready within the same day.  
If you send your transfer request after 6pm,
we will have it ready for you by close of the
next business day.  We will contact you at
the phone number you have provided, if
additional information is required.  We will
call you when your prescription is available.

If you have any questions or concerns, please
feel free to give us a call. 
Prescription Transfer
Patient Information
* First name:
* Last name:
* Date of Birth:
* Phone number:
* Address Line 1:
Address Line 2:
* City:
* State/Province:
* ZIP/Postal Code:
* Pharmacy Name:
* Pharmacy Phone:
Prescriptions to be transferred

Please check the following box if you would like to transfer all of your
prescriptions to Evergreen Pharmacy. Otherwise, please list the prescription
number(s) that you would like Evergreen Pharmacy to fill.
Transfer all of my prescriptions
*Prescription # 1 / Medication Name
Prescription # 2 / Medication Name
Prescription # 3 / Medication Name
Prescription # 4 / Medication Name
Prescription # 5 / Medication Name
Requested Fill Date:
Additional Instructions or Requests:
Who is this prescription for?
Evergreen Pharmacy
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