151 Guy Park Ave, Amsterdam, NY 12010
(518) 212-6020 (518) 212-6062 Free Delivery

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Forms & resources.

Referral forms for providers, intake forms for patients, and the paperwork that keeps insurance and assistance programs moving. Download what you need, send it back to us by fax or in person.

For providers

Specialty referral forms

28 downloadable referral forms across 9 specialties. Search by drug or condition, or filter by specialty. Fax completed forms to (518) 212-6062 or call (518) 212-6020.

29 forms
Cystic Fibrosis Referral Form Download PDF · Cardiology & Pulmonology Repatha & Praluent Referral Form Download PDF · Cardiology & Pulmonology Dermatology Referral Form Download PDF · Dermatology Cosentyx Referral Form Download PDF · Dermatology Endocrinology Referral Form Download PDF · Endocrinology Saxenda Referral Form Download PDF · Endocrinology Lupron Depot Referral Form Download PDF · Endocrinology Osteoporosis Referral Form Download PDF · Endocrinology Diabetic Footwear Order Form Call to request · Endocrinology Crohn's Disease & Ulcerative Colitis Referral Form Download PDF · Gastroenterology Xifaxan & Viberzi Referral Form Download PDF · Gastroenterology Hepatitis C Referral Form Download PDF · Hepatology IVIG Prescription Referral Form Download PDF · Immune Deficiencies Firazyr Referral Form Download PDF · Immune Deficiencies HIV-AIDS Referral Form Download PDF · Immune Deficiencies Sivextro Referral Form Download PDF · Immune Deficiencies Transplant Referral Form Download PDF · Immune Deficiencies Multiple Sclerosis Referral Form Download PDF · Neurology & Behavioral Health Migraine Referral Form Download PDF · Neurology & Behavioral Health Tetrabenazine Referral Form Download PDF · Neurology & Behavioral Health Spravato Referral Form Download PDF · Neurology & Behavioral Health Vivitrol Referral Form Download PDF · Neurology & Behavioral Health Oncology Referral Form Download PDF · Oncology & Hematology Anemia Referral Form Download PDF · Oncology & Hematology Low Molecular Weight Referral Form Download PDF · Oncology & Hematology RA & Inflammation Referral Form Download PDF · Rheumatology Cosentyx Referral Form Download PDF · Rheumatology Krystexxa Referral Form Download PDF · Rheumatology Osteoarthritis Referral Form Download PDF · Rheumatology
For office staff: call us at (518) 212-6020 or fax (518) 212-6062 if you need a form not listed here or have questions about a specific referral.
For patients

Quick tasks

The three things patients ask us about most, handled in a single click or call.

Transfer your prescriptions

Already at another pharmacy? We'll do the transfer for you, usually within a few hours. Just call us with your old pharmacy's name and your Rx numbers.

Call (518) 212-6020

Insurance check

Not sure if we take your plan? We accept all major insurances. Call with your card and we'll confirm in a minute.

Ask about your insurance

Schedule a vaccine

Flu, COVID, shingles, pneumonia, Tdap, and more. Walk-ins welcome for most. Want to schedule? Just call.

See available vaccines
FAQ

Frequently asked questions

Do you really accept all insurances?

We're in-network with Medicare Part D, Medicaid, MVP, CDPHP, Fidelis, Aetna, BCBS, Cigna, Express Scripts, OptumRx, and essentially every major commercial plan. If you have a less-common plan, call us with your card and we'll verify in a minute.

What does free delivery actually cover?

Free delivery means no fees, no minimum order, and no membership required. We deliver throughout Amsterdam and surrounding Mohawk Valley communities. Call us before 2 PM for same-day delivery; later calls go out the next business day.

How do I transfer my prescriptions from another pharmacy?

The easiest way is to call us at (518) 212-6020 with the name of your current pharmacy and the medications (or Rx numbers) you want to move. We'll handle the rest, calling the other pharmacy, coordinating with your doctor if needed, and letting you know when your prescriptions are ready.

Can you help me afford an expensive medication?

Yes, that's one of the things we do best. We actively search for manufacturer coupons, foundation grants, and patient-assistance programs. If a price quote feels too high, don't walk away, call us. We've helped patients save hundreds of dollars on a single prescription at no extra cost.

Can I send my Rx number through your website?

Please don't. Web forms and email are not secure ways to send protected health information. For anything Rx-specific, refills, dosage questions, prescription numbers, please call us at (518) 212-6020. Use our contact form only for general questions.

What languages do you speak?

Our team speaks English, Spanish, and Italian. Just let us know which language you'd prefer when you call or stop by, and we'll make sure you're comfortable.

Need something we didn't list?

Give us a call, Justin will pick up or call you back the same day.