Please include any new prescription(s) along with this form.
DMC Pharmacy Mail Service
Please print all information (Missing or incorrect information may cause delay or the inability to process your order).
New Prescriptions; please include a copy of the front and back of your insurance card for proper processing.
Please submit refill request 10-14 days prior to depletion of medication to allow time for processing and delivery.
DMC Pharmacy Mail Service is available Monday through Friday.
All Prescriptions received before 10:00am will be mailed, in most cases, the same day.
All Prescriptions received after 10:00am will be mailed, in most cases, within 1 to 3 days.
IF YOU NEED THIS MEDICATION WITHIN 24-36 HOURS, YOU SHOULD CONSIDER HAVING YOUR PRESCRIPTION FILLED AT A
DMC ON-SITE PHARMACY LOCATION.
NOTE: All controlled substance prescriptions will be mailed separately and will require a signature at the time of delivery.