Home Delivery - Enrollment
Please read the following directions thoroughly before submitting your Home Delivery form online.
You may also download this form HERE to print and mail it in.
If you have not used HomeTown Pharmacy's Home Delivery Service in the past, please fill out the following form. You will be able to order your refill online or by telephone within 2 business days of submission.
If you are already a Home Delivery customer, YOU DO NOT NEED TO FILL OUT THIS FORM TO USE THE ONLINE REFILL SYSTEM. Simply click HERE or on the Online Refills tile below, choose Home Delivery as your pharmacy and enter your prescription numbers.
If you are unsure whether you are already a Home Delivery customer, or if your information has changed since your last refill, DO NOT FILL OUT THIS FORM. Instead, call our Home Delivery Sevice toll-free at 1-855-849-8555.
Current states HomeTown ships to: Georgia, Massachusetts, Michigan, Pennsylvania
New states are being added frequently - give us a call at 1-855-849-8555 if your state is not listed.
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