Prescription Drug Mail-back Envelope Reorder Form

To place an order for additional mail back envelopes please fill out the form below. If you have any questions about reordering please contact 802-951-5807.

Due to a transition in shipping partners, the medication mail back bags may take longer than normal to arrive. We apologize for the inconvenience.

Reorder Information

The organization receiving this order does not operate 10 or more pharmacy establishments in the United States, while concurrently conducting business in Vermont. *This question is required.

Agree

Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Number of Envelopes You Are Requesting (50 maximum per month) *This question is required.

Name of Location *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Prescription Drug Mail-back Envelope Reorder Form

Contact Information