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These interactive forms make sending prescriptions to Evers Pharmacy an easy process. Simply download the form, type or print the appropriate information and fax to Evers Pharmacy. We encourage you to e-prescribe to make the process even easier. Contact your account manager for pre-printed forms for your local pharmacy.

This section is for prescribing practitioners only. Patients must bring an original prescription to the pharmacy, and cannot fax these referral forms to Evers Pharmacy. Faxed prescriptions will only be accepted by a prescribing practitioner. For best results, download the latest version of Acrobat Reader.

Form Downloads: Administrative