Get Regegmpd

Filling out the Regegmpd form properly is crucial for ensuring your mail service prescriptions are processed accurately. This guide provides step-by-step instructions to help you navigate the form with ease.

Follow the steps to complete the Regegmpd form accurately.

1. Click ‘Get Form’ button to obtain the Regegmpd form and open it in the editor.
2. In the patient section, fill in the required details including your Member ID Number, Patient Phone, Patient Address, City, State, and ZIP code.
3. Ensure you are registered with Walgreens and have current credit card and shipping information on file. To register, you can follow the instructions provided at Walgreens.com/mailservice or use the registration form in your enrollment kit.
4. Once registered, forward this form to your prescriber. They will need to complete the Prescriber section.
5. In the Prescriber section, your prescriber should fill out their name, address, phone number, and fax number. They must also include their signature and the date.
6. Your prescriber will need to specify the Medication, Date, Strength, Directions, NPI#, Quantity (QTY), and number of Refills. This information is critical for the processing of your prescription.
7. If applicable, check the box indicating whether this is a new fax number and ensure all information is completed clearly in black ink.
8. After the form is filled out completely, your prescriber should fax it to Walgreens at the number provided on the form to ensure it's valid.
9. Finally, keep a copy of the completed form for your records. You may also choose to save, download, or print the form for your convenience.

Complete your Regegmpd form online today to ensure your prescriptions are processed without delay.