New Prescriptions - O'Brien Pharmacy

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 Name Last Name
Date of Birth - must be mm/dd/yyyy format * Required
Date Format: MM slash DD slash 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
Phone
This field is for validation purposes and should be left unchanged.