Forms

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

The referral form should be sent to the pharmacy of patient choice for prescription fulfilment.

Upon receipt by altScripts Specialty Pharmacy our team will

  • Verify insurance coverage and file the claim with the insurance provider.
    Provide prior authorization and financial assistance support to ensure patient access.
  • Notify the patient and physician of the prescription status.
  • Contact the patient to coordinate pick-up or delivery of the medication.
  • The pharmacist will educate the patient on their medication(s), including how to maintain adherence and monitor side effects.


A black and white icon of a pill on a white background.

Verify insurance coverage and file the claim with the insurance provider.

A black and white icon of a pill on a white background.

Provide prior authorization and financial assistance support to ensure patient access.

A black and white icon of a pill on a white background.

Notify the patient and physician of the prescription status.

A black and white icon of a pill on a white background.

Contact the patient to coordinate pick-up or delivery of the medication.

A black and white icon of a pill on a white background.

The pharmacist will educate the patient on their medication(s), including how to maintain adherence and monitor side effects.