Complete Rx Returns
For all your Pharmaceutical needs.
Home
About
Services
Package Options
Frequently Asked Questions
Forms
Contact
Requests
Customer Login
Credit Report Request
Use this form to request a credit report.
Pharmacy Name:
*Full Address:
*Contact Name:
*DEA:
*Date of Return:
*E-Mail:
*Phone:
*Fax:
*Preferred Method of Contact:
Email
Phone
Fax
*Debit Memo Number:
Comments:
