These interactive forms make sending prescriptions to Avella an easy process. Simply download the form, type or print the appropriate information and fax to Avella. We encourage you to e-prescribe to make the process even easier.
Contact your account manager for pre-printed forms for your local pharmacy.
This section is for prescribing practitioners only. Patients must bring an original prescription to the pharmacy, and cannot fax these referral forms to Avella. Faxed prescriptions will only be accepted from a prescribing practitioner.
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Need a form that isn't filled out for a specific disease state, or want to create your own custom form? Do you need to order wholesale from Avella? We have referral forms for that too.