Transfer Prescription

Are you no longer satisfied with your current pharmacy? Are you new in town and looking for a new pharmacy to trust? If you said yes to either question, Sooner Discount Pharmacy LLC would be happy to receive your transfer prescription request.

To start transferring your prescription to us, please fill out the form below. Make sure that all information you provide is accurate before submitting.

* = Required Information

Patient Details

First Name *

Last Name *

Date of Birth *

Phone Number *

Address *

City *

State *

Zip/Postal Code *

Pharmacy Name *

Pharmacy Phone *

Prescriptions to be transferred

If you would like to transfer all prescriptions, simply check the box below.

Transfer all my prescriptions

If you would like to selectively transfer your prescriptions, simply start typing to find your medication.

List specific prescriptions to be transferred

Medication Name

Rx1 Med Name

Rx2 Med Name

Rx3 Med Name

Rx4 Med Name

Rx5 Med Name

Prescription Number
From Current Pharmacy

Rx 1 #

Rx 2 #

Rx 3 #

Rx 4 #

Rx 5 #

Security code