Prescription Request / Transfer

In order to provide you with the best care possible, please provide us with the following information.  We will contact your doctor first, to obtain the prescription information.  Then we will process your prescription through your insurance. Finally, we will contact you to notify you of the status of your prescription and how much your co-pay will be.

Note: We are not an open door pharmacy. We only accept Rx’s via fax or phone directly from your physician.

Submit the form below to request your prescription
  • Insurance Information

  • I authorize Avni Apothecary to use the above information to process my prescription, once received from my physician