CareRx Customer Portal

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Customer Information

Power of Attorney (POA) Full Name (if applicable)*

Account Number* (Can be found on your statement.)

POA Full Name (if applicable)

Email Address*

Phone Number

Disclaimer: By completing and submitting this form, you acknowledge and agree that CareRx Corporation and its affiliated pharmacies will discontinue delivery of printed statements for your account effective the next billing cycle and that only electronic statements will be delivered. Electronic statements will be delivered only to the person and email address you have listed above. You may change your billing preferences to receive printed statements for your account by contacting CareRx. CareRx charges a fee of $3.00 plus applicable taxes per paper statement mailed.

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