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Transfer RX

make park chemists your

Primary Pharmacy

Transferring your prescriptions to Park Chemists is easy! Just fill out the information below and we’ll handle the rest. Our staff will communicate on your behalf and make sure we take care of you and all your prescription needs.

*Required fields are starred in red.

Personal Information

Name *
Date of Birth *
Gender *
Insurance card on file
Front of Insurance Card
Max file size 10MB.
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Back of Insurance Card
Max file size 10MB.
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personal Address *

Current Pharmacy Information

If this is being filled out by a caregiver, case manager, or care coordinator kindly include your full contact information (Name, Contact info, Name of facility)
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HOLIDAY HOURS FOR SEPTEMBER

5TH AVE

  • SATURDAY 9/5: 10 AM-5PM
  • SUNDAY 9/6: CLOSED
  • MONDAY 9/7: CLOSED LABOR DAY
  • FRIDAY 9/18: 9AM-6PM
  • SATURDAY 9/19: 10AM-5PM
  • SUNDAY 9/27: 11AM-4PM
  • MONDAY 9/28 CLOSED YOM KIPPUR

4TH AVE

  • MONDAY 9/7: CLOSED LABOR DAY
  • FRIDAY 9/18: 10AM-6PM
  • SATURDAY 9/19: 10AM-3PM STORE ONLY (RX DEPT CLOSED)
  • MONDAY 9/28 CLOSED YOM KIPPUR