Medical Supply Reorder Form

Use this form for exact reorders only of medical supplies previously received from Hartzell's Pharmacy.

For new orders, contact our care specialists directly at 484-240-6440.

Your order will take 3 to 5 business days to complete, provided all required documentation is on file and current.

If you have any questions regarding your order or the order process, please contact our Care Specialist team at 484-240-6440 or csr@hartzells.com

Instructions

1. Patient Information

Fill out this section with your contact information

2. Prescriptions = Medical Supplies

In this section, think of "Prescriptions" as Medical Supplies.

Simply fill out the information accordingly:

[Rx Number]: Number of Medical Supply Items to Order

[Medication Name]: Name of Medical Supply Item

3. Notes for Pharmacy

Let us know of any additional details or requests, and a friendly member of our staff will be in touch very shortly thereafter!

300 American St, Catasauqua, PA

Toll Free: 1-800-325-6856| P: 610-264-5471 | F: 610-264-3048

Hours: Mon-Fri: 9a.m. - 8p.m. | Sat: 9a.m.-3p.m. | Sun: Closed

p: (610) 264-5471

f: (610) 264-3048

info@hartzells.com

Hartzell's Pharmacy, Inc. BBB Business Review