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Submit Form

Fill out the form below to begin on your journey to better medication management



One of our friendly staff members will call you to review your medications and your medication delivery details


Ongoing Support

Your patient care coordinator will call you monthly to provide medication support and schedule your deliveries

  • General Info

  • MM slash DD slash YYYY
  • Patient Contact

  • Prescription Info

  • Current PharmacyCurrent Pharmacy Phone Number 
  • Physician NamePhysician Phone Number 

All information provided will remain STRICTLY CONFIDENTIAL and used only in conjunction with our services. Privacy Policy 

Curant Health is a fully-licensed U.S. pharmacy that has been approved to sell prescription drugs in all states and D.C.