Address: 5821 York Blvd, Los Angeles, CA 90042 Phone: 323.302.8090 Fax: 888.641.7979 Email: contact@yorkdiscountrx.com

Prescription Transfer and Refill

Use the forms below transfer your prescriptions from your current pharmacy
to York Discount Pharmacy or to refill existing prescriptions!

Prescription Transfer Form

Please fill out all fields and click submit to transfer your prescriptions.

Your Name:

Your Telephone:

Current Pharmacy Name:

Pharmacy Telephone:

Special Requests/Message:




Express Refill Form

Please fill out all fields and click submit to submit a refill request.

Your Name:

Your Telephone:

Current Pharmacy Name:

Pharmacy Telephone:

Special Requests/Message: