NOTE: If you get your maintenance prescriptions by mail,
please read this important notice. Your immediate attention may be
required.
To get started using Integrated HMO Pharmacy for your mail-order prescription needs, you will need to fill out the mail-order switch form. Be sure to include:
- your member information in the top section of the form
- payment information in the middle section,
- the list of medications you are currently taking, and
- your prescribing physicians name and phone number in the bottom section.
Integrated HMO Pharmacy will contact your physician directly to obtain new prescriptions for your medication.
NEW ON-LINE PHARMACY FORMS
On-Line Order Form
For assistance with on-line orders, please call: 1-800-633-7928
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