Prescription Transfer Form - Student Health Services - shs wustl 2026

1. Click ‘Get Form’ to open the Prescription Transfer Form in the editor.
2. Begin by entering your Student Name and Date of Birth in the designated fields. This information is crucial for identifying your records.
3. Next, fill in your Student Number and Cell Phone Number. Ensure these details are accurate for any follow-up communications.
4. If you have any drug allergies, please list them in the provided space to inform the pharmacy of any potential issues.
5. In the section for Pharmacy Name, City, and State, enter the details of your current pharmacy along with the corresponding Rx # for each medication you wish to transfer.
6. For each drug, specify its name and strength. Additionally, indicate how many refills remain at your current pharmacy.
7. Once all fields are completed, review your entries for accuracy before submitting the form to ensure a smooth transfer process.

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