To order from Express Scripts, use this form:

Call:

1-800-229-0832
TTY users call 1-800-716-3231
24 hours a day, seven days a week

Mail the completed form to:

Express Scripts
P.O. Box 6500
Cincinnati, OH 45273-8152

To order from Walgreens, use this form:

Call:

1-866-877-2392
TTY users call 1-800-573-1833
24 hours a day, seven days a week

Mail the completed form to:

Walgreens
P.O. Box 29061
Phoenix, AZ 85038-9061