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Express Scripts Home Delivery Mail-order form
Order prescription drugs through the mail from Express Scripts Home Delivery.
Health, Allergy and Medication Questionnaire
Complete this questionnaire for all new mail prescriptions to help protect yourself against potentially harmful drug interactions and side effects. Fill out this form and mail it or submit information via our online form.
Prescription drug reimbursement form
If you didn't have your LifeWise card with you when you filled a prescription and paid full price, you can request reimbursement.
LifeWise members have many different drug benefit options with our plans. Learn more about how your drug benefits work.
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