BERNIES PHARMACY
Prescription Discount Program
Download
Application
Form
At Bernies Pharmacy, we understand that not all patients have insurance available to them. There are also times that insurance companies refuse to pay for a certain drug. For these reasons, we offer a presciption drug discount program. To apply for this program, come into the store to obtain an application form, or right-click the link and click "save target as". Hard copies of the forms must be signed and mailed or had delivered to us at the store. Forms may not be faxed or emailed. This is a discount program, not insurance. The discount program does not apply to custom compounded medications.Adobe reader is required to view and print the form.