New or Transferred Medications

Search for:

For new prescriptions or to transfer a prescription, please fill out the form below.

Pharmacy

Name(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What can we help you with today?(Required)

Refill Medication

Transfer Medication

Specialty Medication

Contact Pharmacist

Which pharmacy location do you prefer?

Rogers

Fayetteville

Springdale

Type your prescription number below:

Type the name of your prescription below:(Required)

Type any additional information your pharmacist may need to know:

Current pharmacy name:(Required)

Current pharmacy phone number:(Required)

Type your prescription number below:

Type the name of your prescription below:(Required)

Which Highlands pharmacy location do you prefer?

Rogers

Fayetteville

Springdale

Type any additional information your pharmacist may need to know:

Which Highlands pharmacy location do you prefer?

Rogers

Fayetteville

Springdale

Type any additional information your pharmacist may need to know:

Type your message for the pharmacist in the box below:

CAPTCHA

Rogers
808 South 52nd Street
Rogers, AR 72758
Phone (479) 936-9900
Fax (479) 936-9944
Springdale
3901 Parkway Circle
Springdale, AR 72762
Phone (479) 334-2430
Fax (479) 587-1366

Fayetteville
North Hills - 3232 N. North Hills Blvd
Fayetteville, AR 72703
Phone (479) 587-1700
Fax (479) 587-1366

Mountain Home
639 Hospital Drive
Mountain Home, AR 72653
Phone (870) 580-5280
Fax (870) 425-6811
Connect with us:

Fayetteville
60 E. Monte Painter Drive
Fayetteville, AR 72703
Phone (479) 695-4234
Fax (479) 571-1986

Rogers
2526 S Pinnacle Hills Pkwy
Rogers, AR 72758

Connect with us:

Site Map Notice of Non-Discrimination Patient Bill of Rights Notice of Privacy Practices No Surprises Act Employee Login