New Prescriptions

O'Brien Pharmacy can fill your new prescription(s) in many ways:

1. Ask your primary care practitioner to electronically send us your prescription.

2. Ask your primary care practitioner to fax us your prescription.  Our fax number is (518) 885-7460.

3. We can call your primary care practitioner to retrieve your prescription.  Please fill out the following information so that we can call to retrieve your prescription.

Patient Information

Name: (required)

First                                                                  Last

Date of Birth: (required)

MM     DD      YYYY

Phone Number: (required)

###      ###      ####

Address: (required)

Street Address

Address Line 2

City

State

Zip Code

Email: (required)

Prescriber's Name: (required)

Prescriber's Phone: (required)

###      ###      ####

Drug Name/Strength

Drug Name/Strength

Drug Name/Strength

Notes: