Family Form | Prodigy Health Rx

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Registration

Starting your journey with Prodigy Health RX is effortless.

Explore comprehensive family healthcare with Prodigy Health RX's Family Plan, designed to cater to the health needs of your entire family. Benefit from accessible, all-inclusive care at a cost-effective rate. Register now with our straightforward form and start your family's journey towards enhanced health and well-being.

Fill out this form now to sign up

First name

Middle Name

Last name

Date of Birth(Required)

Phone

Address(Required)

Address Line 2

City(Required)

State(Required)

Zip Code(Required)

Are you looking to transfer your prescription to Prodigy Health RX?

Male

Female

Other

Family Member Information