Submit A Prescription

UPLOAD A PRESCRIPTION

Use the secure form below to submit a prescription or supporting documentation.

Other Options

FAX

Our secure fax line
1.425.467.6661

LOCAL DROP-OFF

Stop by or arrange for your prescription to be dropped off at your local Bellevue Healthcare showroom.

If you are sending someone of your behalf, please be sure they provide your information to a Bellevue Healthcare team member.

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