Referral Information
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MedPro Rx makes referring simple:
  1. Download the form (see below) which best identifies where your referral originates
  2. Fill out the form as completely as possible, either by typing on it directly or printing
  3. Call, email or Fax your information to us
    Call: 1-888-571-3100
    Fax: 1-800-582-9315
    Email: referrals@medprorx.com
  4. We handle the rest
The forms below are available in PDF format. Select the appropriate link to begin the form download. If you do not have Adobe® Acrobat® Reader™ installed, see the bottom of this page.


MedPro Rx  participates with a variety of health plans and other payors including government agencies, managed care organizations, third party administrators, self-funded groups and various retail prescription plans. We provide services to persons with Medicare B, Medicare D and with numerous Medicaid plans. Our large payor base allows us to provide specialty pharmacy services through most of the United States. We continue to grow our participating payor base with our expanding list of contracts and service locations.

If you have any questions, call us at 1-888-571-3100 and one of our MedPro Rx pharmacists will be glad to assist you.



   Adobe® Acrobat® Reader™ is available at no charge from the Adobe® web site. Click on the logo to start your download.