Health Care Connections

402 South Main Street Suite 100 Raeford, North Carolina 28376

(910) 848-0630

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Health Care Connections

402 South Main Street Suite 100 Raeford, North Carolina 28376

(910) 848-0630
Closes at {{closingHours}}
Directions
Online Refills
Services

Change Store

Prescription Transfer Request

Fill out this form to request to have your prescription transferred to Health Care Connections.
This form will be delivered via secure fax, and we will notify you when your prescription is ready to pickup.

Patient Information

First name *

Last name *

Phone Number *

Email Address *

Date of Birth *

Prescription Information

Existing Pharmacy Name *

Existing Pharmacy Phone Number *

Prescription # *

Prescription Name *

Comments

* Indicates required field