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451 W. Front St., Evergreen, AL 36401 | Phone: (251) 578-2273 | Fax: (251) 578-0003 | Mon-Fri 8:30am - 5:30pm | Sat-Sun Closed

New Prescriptions

We would love the opportunity to serve as your trusted prescription provider.
Please fill out the form below and we will take it from here!

You must bring original prescription with you when you come to pickup.

Pharmacy Location

First Name

Last Name

Email Address

Phone Number

Birth Date (XX/XX/XXXX)

Provider Name

Provider Phone Number

Medication Name

Strength / Quantity

Medication Name

Strength / Quantity

Medication Name

Strength / Quantity

Medication Name

Strength / Quantity

Message to Pharmacist

Our commitment to patient care and health is priority one here at Pharm-a-Care Pharmacies.

We believe in the value of providing personalized service and quality products.

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Contact Us

Pharm-a-care Evergreen
451 W. Front St., Evergreen, AL 36401
(251) 578-2273 - (251) 578-0003

Pharm-a-care Georgiana
402 Meeting Ave., Georgiana, AL 36033
(334) 376-2000 - (334) 376-2277