New Patients

Healthstat Rx offers the support you need so you can successfully follow your medical professional's directions to treat your chronic disease or condition.

Just like medications may affect individuals differently, staying compliant to therapy presents different challenges as well. With our extensive experience in medication management, we offer solutions so you can be compliant to therapy and overcome these diverse barriers.

HealthStat Rx removes potential roadblocks that lead to non-adherence. We offer specialized pharmacy care to ensure you receive the proper education, support and pharmacist counseling to achieve the best results in therapy.

We offer friendly refill reminders, dedicated patient care managers and regular follow up to check on your progress. For convenience, we also provide home delivery of medications and bubble packaging at no additional cost.

To have your complimentary personalized medication plan created by one of our experienced pharmacists, contact us.

Transferring a prescription from another pharmacy to HealthStat Rx is easy.  In fact, it can all be done quickly and easily online!  Here is how it works:

1. Provide your contact information, the name, and phone number of the transferring pharmacy, as well as certain information about the medication and prescribing physician.
2. Provide your contact information, the name, and phone number of the transferring pharmacy, as well as certain information about the medication and prescribing physician.
3. HealthStat Rx will contact the pharmacy where your prescription is currently on file to get the information needed to fill your prescription. If the prescription has no remaining refills, we will contact the prescribing physician.

 

Patient's Name:	*
Patient’s Date of Birth:	Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 *
Patient’s Address 1:	*
Patient’s Address 2:
Patient’s Address City:	*
Patient’s Address State:	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *
Patient’s Address Zip:	- *
Patient’s Phone Number:	- - *
Patient’s Email:	*
Current Pharmacy Name:	*
Current Pharmacy Phone Number:	- - *
Physician’s Name:
Physician’s Phone Number:	- -
Prescription Card Member ID#:
Prescription Card BIN#:
Prescription Card Group#:
Patient’s Medication: Patient’s Medication Rx Number: Remaining medication (days): 1 2 3 4 5 6 7 8 9 10 Add More
All information provided will remain confidential. Privacy Policy