Rx Transfer - Transfer Your Prescription Online

Transfer Your Prescriptions

Transfer your prescriptions online to George's Pharmacy & Medical Equipment. Receive medications quickly and conveniently with our delivery services throughout Indiana, whether you need them sent to your home or workplace. You can also get your prescriptions in-store, through curbside service or by using one of our pharmacy drive-thrus. If you have any questions, contact us. Our friendly pharmacy team is happy to help.

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Customer Information
First Name *
Last Name *
Date of Birth *
Last 4 SSN digits *
Phone *
Address *
Address Line 2
City *
State *
Zip *
Country *
Pharmacy Name *
Pharmacy Phone *
Insurance Card (front and back) ctr + click to attach multiple images

Prescription Information

If you would like to transfer all your prescriptions, please check the box below. (We recommend this for your health and safety) Transfer all of my prescriptions

List up to 5 prescriptions that you want to transfer. If you checked the above box to transfer everything, you don't need to fill this out.

Medication Name

Prescription Number from Current Pharmacy

Time of Day Morning Noon Evening Bedtime

Add Prescription +

Primary Doctor Information
Primary Doctor First Name *
Primary Doctor Last Name *
Primary Doctor Phone *
How did you hear about us?*
Name of Person Who Referred You *
Note or Special Instructions:

Transfer Rx

Transfer Your Prescriptions

Customer Information

Prescription Information

Primary Doctor Information