375 Rolling Oaks Dr., Suite 150 Thousand Oaks, CA 91361

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Rx Refill

Let us be the provider of your needed prescriptions.

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Auto Refill

Automatically refill your prescription without hassle.

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Rx Transfer

Transfer your prescriptions to us the easy way.

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To view fillable pdf, please download first adobe reader here.

Here are the steps to print and submit the fillable Application Form:

  1. To view the fillable PDF, you will first have to download Adobe Reader here.
  2. Next, click the download button located at the top right corner.
  3. After, fill out the form.
  4. Then, you save the file. You are given two options to submit your application:
    1. Compose an email, attach the save file, and send it to info@westcoastrx.com.
    2. Print the filled out form, scan it, and send it to info@westcoastrx.com.