Forms

Thank you for your interest in PrescribeWellness. We can’t wait to get started!

To start activation, we need your Data Authorization Form. Please take a moment to complete the form appropriate for your Dispensing System. If you have questions at any time, please email us or call us at 800-960-8147.

Data Authorization Form

Click on your Dispensing System below.

If your Dispensing System is not listed, click on All Other Dispensing Systems.