Referral Forms

Refer a Patient to CarePartners Pharmacy

E-Prescribe

Please e-prescribe to CarePartners Pharmacy (326 Peterson Rd. Libertyville, IL 60048)

Fax Prescription

Please fax hard copy prescription to CarePartners Pharmacy at:
Toll Free Fax Line: (866) 832-7180

Call-In A Prescription

You can always call-in prescriptions for your patients to CarePartners Pharmacy at:
Toll Free Phone Number: 866-832-7171

Select and fill out a referral form, then upload it using the form below.

Securely upload a patient prescription

Name

First Last

PDF Upload

Drop files here or

Accepted file types: pdf, Max. file size: 32 MB.

Doctor Signature

Phone

This field is for validation purposes and should be left unchanged.

326 Peterson Rd.
Libertyville, IL 60048

866-852-0202
Mon-Fri 8:30am to 5:30pm CST

info@CarePartnersRx.com