Fill New Prescriptions
Already have a paper prescription from your doctor? Print, fill out and mail us the Prescription Order Form with the paper prescription attached.
Prescription Order Form
Prescription Order Form(Spanish)
Need a new prescription? Ask your doctor to print, fill out and fax us the Prescriber Fax Form
Prescriber Fax Form
Prescriber Fax Form (Spanish)
Register for Home Delivery
Want to register for AllianceRx Walgreens Prime home delivery online?
Print, fill out and mail us the Home Delivery Registration Form to enroll yourself or family members in AllianceRx Walgreens Prime home delivery.
Home Delivery Registration Form
Home Delivery Registration Form (Spanish)