Transfer Your Prescription To wellnesslabRX Get Started Fill out the form to start your transfer Transferring prescriptions to wellnesslabRX is easy: Simply fill out the form below and make sure to add all the fields required unless marked optional. For more than one prescription, come back to this page and fill out the form again. Please enable JavaScript in your browser to complete this form.First Name *Last Name *Date of Birth *Your Phone Number *Previous Pharmacy Name *Previous Pharmacy Zip Code *Previous Pharmacy Phone # *Insurance Card Holder IDPCN BINPlease provide all medication names and prescription numbers from your previous pharmacy that you would like to transfer. *Check One:New PatientExisting PatientSubmit