You may print the necessary forms and mail/fax/email them to Kent Station Pharmacy. Following are the documents that Kent Station Pharmacy will need to process your medication request. Please remember to include your name, your child’s name and the school name on all correspondence. PLEASE FILL OUT THE CONTACT INFORMATION COMPLETELY! If you have any questions about the registration process please contact us at (860) 927-3725.
In addition, we require the following:
- A copy of the front and back of the child’s/parents prescription insurance card. This can be uploaded during registration. Alternatively, it can be faxed or mailed to the pharmacy.
Registration: Please download, complete the following forms, provide documents as indicated, and send to Kent Station Pharmacy:
- Student Registration Form
- Parent/Guardian – Prescription insurance Information
- A copy of the front and back of the child’s/parents prescription insurance card.
- Parent/Guardian – Credit Card Authorization Form
- Kent Station Pharmacy Notice of Privacy Practices
Forms can be sent via mail, fax, or email. Our contact information is as follows:
Kent Station Pharmacy
38 North Main Street/ Box 632
Kent, CT 06757
phone: (860) 927.3725
fax: (860) 927.3895
email: schoolinfo@kentstationpharmacy.com