Bonita Pharmacy

Are you getting the kind of quality service you deserve in your current pharmacy? Are your medications wrongly refilled or late? It might be time for you to transfer your prescriptions to Bonita Pharmacy! We do our best to attend to your concerns on a timely and accurate manner. Transfer your prescriptions to us by filling out the form below.

First Name

Last Name

Date of Birth

Phone Number

Country

State

City

Address

Zip/Postal Code

Pharmacy Name

Pharmacy Phone

Prescriptions to be transferred

Transfer

Transfer all my prescriptions

If you would like to selectively transfer your prescriptions, simply start typing to find your medication.

List specific prescriptions to be transferred

MEDICATION NAME

PRESCRIPTION NUMBER FROM CURRENT PHARMACY

Rx1 Med Name

Rx 1 #

Rx2 Med Name

Rx 2 #

Rx3 Med Name

Rx 3 #

Rx4 Med Name

Rx 4 #

Rx5 Med Name

Rx 5 #

Transfer Rx