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Get Cvs Mail Fax Order Form

Lease use blue or black ink, capital letters, and ll in both sides of this form. New Prescriptions - Mail your new prescriptions with this form. Number of New prescriptions: Number of Re ll prescriptions: Re lls - Order by Web, phone, or write in Rx number(s) below. FOR FASTEST SERVICE, order refills at www.caremark.com or call the number on your prescription benefit identification card. A Shipping Address. To ship to an address different from the one printed above, please make changes.

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