Request refills on the go using the Rx2Go app for your mobile device!

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Colleges & Schools

Andrews Pharmacy provides free delivery to many area schools.  We provide a simple solution to handle all of your prescription + non-prescription needs.  When a prescription is ordered, we will have the medication delivered to your school for convenient access.  In addition, you can order your refills from your smart phone or computer as well.

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Complete our Form below to Setup a Secure Account:

* Required Fields

Order Information

Name*

Day of Birth*

Male or Female*

Name of School*

Student Phone Number*

Student Secondary Phone Number

Student Email*

Address Street 1*

Address Street 2

Address City*

Address State

Address ZIP*

Student's Insurance Information

RX BIN #*

RX GROUP #*

RX PCN #*

Cardholder ID #*

Primary Care Physician Name Primary Care Physician Phone Number

Add Additional Physicians

Any allergies?

Allergy Description

Add Allergy

Do you take medications? Include over the counter medications and vitamins

Name Strength Quantity
You may use decimals		 Notes
Morning:
Noon:
Evening:
Bedtime:

Add Medication

Billing Address Street 1*

Billing Address Street 2

Billing Address City*

Billing Address State

Billing zip*

Billing address same as shipping address

Shipping Address Street 1*

Shipping Address Street 2

Shipping Address City*

Shipping Address State

Shipping Zip*

Credit Card Number*

Credit Card Verification Code*

Name on Card*

Credit Card Expiration Month

Credit Card Expiration Year

I Authorize Andrews Pharmacy to bill my credit card on a recurring basis for all products and services