Medicare Part B Customer Contact Form

Please complete the information below, including the best time to call. You will be contacted by a specially trained representative who will answer your questions and determine your eligibility for Medicare Part B benefits. By submitting this form, you consent to a Walgreens representative contacting you about Walgreens' health care products and services, including diabetic supplies, at any of the addresses you provide below.



Your Information

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(e.g. 555-555-5555)
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Prefered time of contact

 
 
 
 
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(100 character limit)