Transfer Your Prescriptions!
Become a Patient with Us Today!
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please select the Community Pharmacy Location you would like to use.
*
Please Select
Denton Teasley (4400 Teasley Ln. #100 Denton, TX 76210)
Corinth (3001 FM 2181 #450 Corinth, TX 76210)
Flower Mound (1001 Cross Timbers Rd. #1170 Flower Mound, TX 75028)
Name of Previous Pharmacy
*
Phone Number of Previous Pharmacy
*
Please enter a valid phone number.
Format: (000) 000-0000.
What prescriptions would you like to transfer to Community Pharmacy?
Optional notes to pharmacy
Following submission, a member of our team will reach out to confirm your information prior to transferring your prescriptions. We look forward to serving you. Welcome to The Community!
Submit
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