Get Primemail

Filling out the Primemail Prescription Fax Order Form online is a straightforward process. This guide will assist you in completing each section of the form efficiently, ensuring that you provide all necessary information accurately.

Follow the steps to complete your Primemail order form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the prescription section, enter the name of the person for whom the prescription is written, along with the date and their address and phone number.
3. Provide your physician's details. Make sure to notify your doctor to complete the prescription section and fax it directly to PrimeMail at 888.214.1811, as orders not faxed from a licensed physician’s office will not be processed.
4. Complete the member, patient, and payment sections of the form clearly using black ink only. Include your credit card information, which is required at the time of submission.
5. In the patient section, fill in the name, date of birth, and email address of the patient, selecting the appropriate gender.
6. Indicate any drug allergies and health conditions in the respective sections, providing as much detail as necessary.
7. In the payment section, fill in your credit card information along with the expiration date. Make sure the credit card holder's signature is provided.
8. Review all sections of the form for accuracy before finalizing the submission.
9. Once completed, save your changes, and decide whether to download, print, or share the form as needed.

Begin your document completion process online today!