You may chose ANY of the following options. Option number 4 provides the fastest way to get your prescriptions filled, while option 1 is for those individuals who do not need to have their prescription filled in the next few weeks.

1. BY MAIL: ENROLLMENT – Complete the Printable Enrollment Form (pdf), and mail it to the address provided on the Enrollment Form. Within ten days after your completed form is mailed, you will receive an enrollment packet and your ID card. The packet will include an order form, a notice of Privacy Statement and additional instructions about how to place an order.
   
   You can enclose a check or money order, or pay by credit card. Refer to Payment Options for additional information.
    
2. BY MAIL: ENROLLMENT & INITIAL ORDER – Complete the Printable Enrollment Form (pdf), Drug Order Form (pdf), and Privacy Acknowledgement (pdf), and mail them along with your prescriptions and payment information to the address provided on the Order Form. (Note that this address is different than the one for the Enrollment Form.)
   
   You can enclose a check or money order, or pay by credit card. Refer to Payment Options for additional information.
   
   
3. BY FAX: ENROLLMENT & INITIAL ORDER – Complete the Printable Enrollment Form (pdf), Drug Order Form (pdf), and Privacy Acknowledgement (pdf), and fax them to the fax number provided on the Order Form. You will need to provide credit card information for payment purposes. Refer to Payment Options for additional information.
   
   You will need to provide your physician's phone number and the name of the prescriptions you need to have filled. You will then need to contact your physician about the prescription you need to have filled and determine how he/she wants to get the prescriptions to the PBM Plus Mail Service Pharmacy.
   
   
• Your physician can call the PBM Plus Mail Service Pharmacy and give them the prescription information; a toll free number is provided.
• Your physician can fax your prescription information to the PBM Plus Mail Service Pharmacy through our toll free fax number.
• We can call your physician if he/she requests.


4. BY PHONE: ENROLLMENT & INITIAL ORDER – Before calling, please gather the information requested in the Enrollment Form (pdf) and Drug Order Form (pdf), and review the Privacy Acknowledgement (pdf). You will also need to have the following information ready before calling:
   
   
• Your physician's name and phone number.
• The name of the prescriptions you wish to have filled.
• Credit card information for payment purposes. Refer to Payment Options for additional information.

When you've gathered the necessary information, call our customer service deparment at 1-800-736-0403.