AscensionRxForm | Ascension

Step 1: Set up an Ascension Rx account

Plan Information

Who is this medication for? *




Contact Information

Text message updates will be sent to this number.

Medications will be delivered to this address.

The following states are currently not eligible: Arkansas, California, and Louisiana. SmartHealth members will be contacted through your email when your state becomes available.

To review the full AscensionRx Terms of Service, click here

Communication preferences *

As a benefit of Ascension Rx, you may receive updates on your medication transfer via text message. View the full consent for electronic communications.
By entering my mobile number and checking this box, I agree to receive updates from Ascension Proactive Communications. Message frequency varies. Message and data rates may apply. Text HELP to 65069 for help, text STOP to cancel. More information is available at Mobile Terms of Use and Privacy Policy.

Step 2: Talk to your doctor

Need help? Call 1-833-Meds-ARx