Preferred Pharmacy Information

In an effort to serve you and your child better, we now are able to send prescriptions electronically. This process will help reduce medication errors and reduce the time you have to wait for a prescription to be filled. In order to do this efficiently, please complete the form below. Please know that this form does not obligate you to use the pharmacy you submit; it simply allows us to store the information that will most commonly be used.

If you have more than one child who receives pediatric care at Interlachen Pediatrics, please list them in order that corresponds with the order used in "Date of Birth" field.