Norton Rx Transfer Request

Transfer Your Prescriptions to Norton Pharmacy

Use this form to transfer your prescriptions to Norton Pharmacy, including eligible home delivery medications. Our pharmacy team will coordinate with your current pharmacy to transfer your prescriptions and let you know when they’re ready for pickup.

Patient’s first name* (required)

Patient’s last name*

Parent/caregiver’s name (if prescription is for a minor) (optional)

Patient’s date of birth* (required)

Patient’s address

City

State

ZIP Code

Phone number*

Email address*

Current pharmacy name*
Enter a pharmacy other than Norton Pharmacy. If your prescription already is with a Norton Pharmacy, you may change your pickup location or request delivery through Norton MyChart.

Current pharmacy phone number*

What prescriptions would you like to transfer?*
Prescriptions you transfer will also include any remaining refills.
Please enter prescription names and doses.

Choose a Norton Pharmacy location or select home delivery if located in Kentucky or Indiana.*