Print a Prescription Order Form

We understand some customers prefer to mail us their new prescriptions instead of placing their order online. You may also need to use this form for prescriptions that cannot be called in or faxed.

Printable Prescription Order Form 

Please allow two weeks for delivery from the date you mail your order.

Visit Walgreens Mail Service if you are looking for mail order prescriptions.

Questions? Send e-mail to or call us toll-free at (877) 250-5823, 24 hours a day, 7 days a week.