Submit Prescription

Please upload a valid prescription issued by a licensed healthcare provider. If you need assistance or do not have a digital copy, contact sales@caremedixia.com.

Secure Upload Portal

Full Name *

Please enter your full name.

Email Address *

Please enter a valid email address.

Phone Number *

Please enter your phone number.

Order Number (Optional)

Prescription File *

Click to browse or drag file here

Supported formats: PDF, JPG, PNG (Max 5MB)

Please upload your prescription file.

Additional Notes (Optional)