• Bank's Apothecary Sublocade Delivery Request Form

    This May NOT be used as a Prescription Order Form
  • Sublocade delivery requests received by Bank's Apothecary will ship a minimum of one business day after receipt of this form.

    In order to avoid delays receiving your medication, please submit all delivery requests a minimum of 2 business days prior to the date your office is requesting delivery.

    Questions? Call 267-921-0921.

    Medication Will Not Be Sent Unless All Lines Have Been Completed

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