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Download the COVID-19 (Coronavirus) Resource Guide (as of June 28, 2021), created especially for our valued customers.

Pharmacy Forms

PDF  Mail Service Pharmacy Registration & Order Form (Spanish) – AllianceRx Walgreens Prime by Walgreens Mail Service

Use este formulario para inscribirse/remitir su primera orden de receta.

PDF  Mail Service Registration & Prescription Order Form – AllianceRx Walgreens Prime by Walgreens Mail Service

Use this form to register or submit your first prescription order. ID: W0319-1118

PDF  Prescription Drug/COVID-19 At-Home Test Kit Claim Form

Use this claim form to submit eligible pharmacy expenses for reimbursement, including COVID-19 at-home test kits you paid out of pocket for. You have to submit one claim form for each person and each prescription. Full instructions can be found on page 2. ID: 3272 NJ 03/22