Electronic Enrollment Forms – Download these fillable forms for your patients

Dermatology A-G
Dermatology H-Z
Free Health
HIV Co-Infection
Multiple Sclerosis
Rheumatology A-H
Rheumatology I-Z
Specialty Pharmacy

Download pdf. Fill out the fields electroncially. Print form. Sign and fax to 877.771.4633.

We understand that physicians don’t have time to worry about whether the medications they prescribe are filled and delivered properly. That’s why MedCart Specialty Pharmacy is so dedicated to excellence in everything we do.

Whether we’re providing complete therapy management programs, or injectable, infusible and oral pharmaceutical treatments, our goal is to ensure compliance and reduce the chance of complications for your patients. Every prescription we fill includes specific patient education materials and is backed by dedicated patient care coordinators — plus a team of experts who specialize in complex clinical care and are available around the clock to answer questions. What’s more, every order is delivered at no charge to you or your patients.

We coordinate with physicians’ offices to make sure all necessary paperwork is completed and submitted, to expedite the prior authorization process. In addition to customized communication forms and fax forms we provide to every physician’s office, our experienced clinical and hospital liaisons can help ensure accurate, trouble-free administration.

We also reduce the burden on your staff, because our patient care coordinators monitor the treatment you prescribe, work with patients to minimize side effects and answer questions patients may have during their therapy. What’s more, we provide monthly medication use reports, including online access.