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*991×Home Delivery Registration & Prescription Order Form991Prescription Drug Plan: Capital Blue Cross Use this form to register/submit your first prescription order. You can also register at alliancerxwp.com/homedelivery

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How to fill out express scripts mail order

01

Visit the Express Scripts website or call customer service to request the mail order form.

02

Fill out all required information on the form, including your personal information, prescription details, and payment information.

03

Make sure to include the original prescription from your doctor, as well as any necessary documentation or authorization forms.

04

Double check the form for accuracy and completeness before submitting it.

05

Send the completed form, along with the original prescription, to the address provided by Express Scripts for mail order services.

Who needs express scripts mail order?

01

Individuals who take prescription medications on a regular basis.

02

People who prefer the convenience of having their medications delivered to their doorstep.

03

Patients who have difficulty getting to a pharmacy in person.

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What is express scripts mail order?

Express Scripts mail order is a service offered by Express Scripts that allows individuals to order prescription medications through the mail.

Who is required to file express scripts mail order?

Individuals who are enrolled in an eligible health plan that partners with Express Scripts may be required to file for mail order service.

How to fill out express scripts mail order?

To fill out express scripts mail order, individuals typically need to provide their prescription information, shipping address, and payment details through the Express Scripts website or customer service hotline.

What is the purpose of express scripts mail order?

The purpose of express scripts mail order is to provide a convenient way for individuals to receive their prescribed medications without having to visit a pharmacy in person.

What information must be reported on express scripts mail order?

Information such as prescription details, shipping address, and payment information must be reported on express scripts mail order forms.

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