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Transfer your prescriptions to Rexall.

Transfer Prescriptions using Request Form

Complete the form to transfer your prescriptions.

All fields are required unless marked optional.

Patient Information

Transferring Pharmacy Location

Pharmacy Being Transferred To

Prescription(s) to be Transferred

Please provide us with drug name or prescription number for each of the prescriptions you would like to transfer to Rexall.

Important Note

Rexall is committed to protecting the privacy of our customers’ information. Any and all information provided on this form will be kept strictly confidential in accordance with our privacy-policy.

By submitting this form you are giving consent for a Rexall representative to contact the transferring pharmacy indicated to complete your prescription transfer request. Prescription transfers occur digitally or via facsimile, and Rexall may use third party service providers to facilitate a prompt transfer.