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Transfer Your Prescription

Pls fill out the information fields below and click on the red "REFILL Prescriptions" button. HealthSource Pharmacy will be in touch shortly. Required fields indicated by *.

First Name
Last Name *
Address *
Daytime Phone Number *
E-Mail *
Name of Pharmacy original Rx filed *
Rx Number (if available)
Name of Medication *
Phone Num. of Pharmacy *
Health Source Location
you want to fill Rx *
Special Instructions

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Transfer Your Prescription to HealthSource Pharmacy and receive up to
$50 Gift Certificate*

*Valid only for new customers. Receive $10 for each transferred prescription. Limit 5 perscriptions per person. Transferred prescriptions must be filled within 30 days. Gift Certificate is good for any non-prescription purchase.

Offer valid only on prescriptions transferred from another pharmacy that have not been filled previously at any HealthSource Pharmacy. See pharmacist for additional details.
Why transfer your prescription to HealthSource Pharmacy?
Here are a few great reasons:
  • Personalized Caring Service - Get the best of what a neighborhood apothecary can offer. We invite you to treat yourself to a better pharmacy experience.
  • We welcome all major insurance plans and you pay the same co-pay. Upon request, we can even provide a report of your prescription history for your tax planning.
  • Our Specialty Pharmacy Team provides highly customized products and services for many chronic and complex conditions. We specialize in Oncology, Fertility, Women's Health, Infectious Disease, Animal Health, Pain Management, Transplant, and Dialysis.
  • We tailor our services around your needs - You are in charge. Whether you need us to deliver at a specific time, or you would like us to order specific brand of a product for you, we always remember who the customer is.
  • Convenience - We will fill most prescriptions within 10 minutes, and we offer emergency deliveries. We customize our services to make your life a little easier.

Personal Information
Health Source Pharmacy provides this notice to explain its practices regarding collection and use of personal information through this website (the "Site"). We will not disclose, sell, or rent any of your identifiable personal information to any third party, unless approved by you, or required by law. Health Source Pharmacy may offer you access to certain information by e-mail, and may distribute your e-mail address and name to external service providers who would manage this process for us. These service providers have agreed not to sell or distribute your information to any other party. Instructions to unsubscribe will be included in each e-mail message. Health Source Pharmacy may share non-personal, anonymous, summary or aggregate user data with certain affiliates and other third parties. Please note that, although Health Source Pharmacy aims to protect your personal information against unauthorized disclosure, the firm cannot guarantee that your personal information will never be disclosed in a manner inconsistent with this policy.

Health Source Pharmacy uses a variety of security measures to protect your personal information from unauthorized access, use, or disclosure, including the use of Secure Socket Layer (SSL) encryption, when it transmits your personal information over the Internet.

If you have any questions or comments about our privacy policy, please feel free to contact us at 212-481-6600.