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Our Services
Customized Medications
Opthalmic Drops
Men’s Health
Women’s Health
Hormone Replacement Therapy
Kaiser Permanente Members
Kaiser Permanente Members
Fill/Refill Rx
Rx Bill Pay
Auto-Refill Program
Resources
How to Apply Eyedrops
Credit Card Authorization Form
Patients
New Patients
Fill/Refill Rx
Rx Bill Pay
Auto-Refill Program
Resources
How to Apply Eyedrops
Credit Card Authorization Form
Providers
FAQ
Home
About
About Us
Accredited Partners
Contact
Services
Our Services
Customized Medications
Opthalmic Drops
Men’s Health
Women’s Health
Hormone Replacement Therapy
Kaiser Permanente Members
Kaiser Permanente Members
Fill/Refill Rx
Rx Bill Pay
Auto-Refill Program
Resources
How to Apply Eyedrops
Credit Card Authorization Form
Patients
New Patients
Fill/Refill Rx
Rx Bill Pay
Auto-Refill Program
Resources
How to Apply Eyedrops
Credit Card Authorization Form
Providers
FAQ
Home
Credit Card Authorization Form
Credit Card Authorization Form
Download our Credit Authorization form below. Word doc or PDF formats available.
Credit Card Authorization Form - Word Doc
Credit Card Authorization Form - PDF
Our Pharmacy Hours
Monday - Friday: 9am - 6pm
Saturday: 9am - 12pm (phone hours)
Sunday: Closed
Rancho Park Location
