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Add Service Request Forms

Add ready-made Pharmacy Service Request Forms to your MedMe account. Choose from available forms including Transfer Request, Refill Request, Delivery Request, Rx Extension, Blister/Compliance Pack Request, and Vaccine Request

Written by Albert Lam
Updated today

Let your patients submit common pharmacy requests online — no phone call needed.

Each form gets its own link, so you can embed individual forms or the full collection directly on your pharmacy website. You can choose to receive a daily email with all the new form submissions.

Choose from these available forms:

  • Prescription Refill (example)

  • Prescription Delivery Request (example)

  • Prescription Extension Request (example)

  • Prescription Transfer Request (example)

  • Blister/Compliance Pack Request (example)

  • Vaccine Request Form (example)

Note: to view the example forms, you might need to log out from your MedMe account if you're already logged in.

To request one or multiple forms to be added to your account:

A MedMe team member will reach out within 3-5 business days.

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