Assistance With Common Support Issues

About

Only pharmacies that are connected to Surescripts network are able to send prescription refill requests electronically - right to your practice computer. Pharmacies that never send you refill requests electronically are likely not connected. Click here for a list of connected pharmacies in your state.

If you are receiving both electronic and faxed refills from a pharmacy that is connected to the Surescripts Network, you can report this issue to your vendor or report it directly to Surescripts using the form below. Before reporting this issue, we recommend you complete our checklist to determine if the refill could have been faxed for a legitimate reason.

IMPORTANT: Please only report one case per chain pharmacy. As an example, if you are receiving faxed refills from multiple Walgreens stores in your area, you only need to report one location. The incident will be researched and corrected (if necessary) at the chain headquarter level. There is no need to report each individual Walgreens store. Report each chain separately, e.g., if you are receiving faxed refills from CVS/pharmacy, Rite Aid, and Walgreens stores in your area, you should complete the form below three times -- once for each chain. You can also report faxed refills to your software vendor via your standard support protocol. Please report faxed refills from mail-order pharmacies directly to your software vendor

Your Information (All fields must be completed):
DEA Number:
Prescriber First Name:
Prescriber Last Name:
City:
State:
Zip:
Fax Number:
Phone Number:
Email Address:

Select Vendor

Information About the Pharmacy (all fields must be completed -- In most cases the following information can be found on the refill fax):
Pharmacy Name:
Store Number:
City:
State:
Zip:
Pharmacy Phone Number:
Pharmacy Fax Number:

Information about the faxed refill request that you would like to report (all fields must be completed):
Approximate date/time you received the fax(es):
Approximate number of faxes received:
When did you start e-prescribing?
Have you sent at least 5 new prescriptions electronically?
Is the prescription for a Controlled Substance?
Have you contacted anyone at the pharmacy? Name of the individual you contacted:

*Please use the following box to tell us anything else you think we should be aware of with regards to this pharmacy and/or the faxed refill request:

Surescripts may need to contact your vendor for assistance with researching this issue or to obtain additional information such as a copy of the fax(es). By leaving this box checked you are authorizing Surescripts to follow up with your e-prescribing vendor.




*Important Notice: Protected Healthcare Information (PHI) should never be transmitted via this Web site. PHI is any data which can be used to reasonably identify a patient (as defined within the HIPAA Privacy Rule, the HIPAA Security Rule, or elsewhere within the overall HIPAA regulations), or which specifically contains individually identifiable health information. As one example, do not include the Rx Number as this is considered PHI.