Transfer RX Form
Please fill out the information below that will help us transfer your prescription number from your old pharmacy to B & B Pharmacy. Any questions below with a red asterix beside it is a required question. If you have any additional questions or remarks please insert it in the box at the very end or give us a call at (828) 252-2718. Thank you for choosing B & B!
Step 1 of 2: Information About You
Your Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Please hit continue below to move on to the next step.
Next
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This form was created inside of B & B Pharmacy.