Simply download the form, type or print the appropriate information and fax it to us. Pharmacy Fax (714) 550-9336

This section is for prescribing practitioners only. Patients must bring an original prescription to the pharmacy, and cannot fax these referral forms to us. Faxed prescriptions will only be accepted from a prescribing practitioner.

Our staff is ready to help, please contact us for assistance. Pharmacy Phone (714) 550-9798