New User Form
If you are new to the pharmacy please complete our new user form and provide a copy of the front and back of your prescription insurance card.
New User Form
For examples of prescription insurance cards click here.
This form can be emailed to apothecary@colorado.edu or faxed to 303-492-4874.
Transferring Your Prescription(s)
We can transfer prescriptions from your home pharmacy to The Apothecary. Please allow 24-48 hours to transfer. If there are any issues, we will contact you.
Complete one form per prescription:
Prescription Transfer Request Form
This form can be emailed to apothecary@colorado.edu or faxed to 303-492-4874.
Please note that email is not a secure method of communication. There is always some risk that health information that may be contained in such an email may be disclosed or intercepted by unauthorized third parties. These forms can also be securely faxed to 303-492-4874.