Prescription Enrollment Forms

Please ask your prescribing practitioner to fill out & fax the specific medication enrollment form for the prescription you are seeking. Following an appointment, patients must bring their prescription to Epic Pharmacy. However, only practitioners can fax the following prescription forms. Thank you for choosing Epic Pharmacy!

Antipsychotics

Enrollment Form

Arthritis And Rheumatology

Enrollment Form

Dermatology

Enrollment Form

HIV

Enrollment Form

Oncology

Enrollment Form

Migraine

Enrollment Form

Immune Globulin

Enrollment Form

Transplants

Enrollment Form

Gastroenterology

Enrollment Form

Hep C

Enrollment Form

Intravenous Immune

Enrollment Form

Neurology

Enrollment Form