New Member Registration Call 855.816.7257 for help with registration.FREE (BASIC)$0.00FREE * Order Prescription Medications, Non-Prescription (Over the counter) Medications, and Medical Supplies from our Online Store. * Get access to the Pill Pals Store App on both Android and Apple * Get Discounts on other products and services like Telemedicine from Pill Pals Partners and Affiliates. View our Discounts Directory to learn more. * Rx 2 Go App allows you to get refills NextPreviousSign Up For Pill Pals * Choose A Username * Create A Password (at least 12 characters, one Uppercase letter, one Number, and one Special Character)Strength: Very Weak * Confirm Password * Email Address * First Name * Middle Name * Last Name * Phone Number * Date of Birth (DD/MM/YYYY) For example, December 25, 2021 is 25/12/2021Race / Ethnicity - Please provide us with this information so that we can manage your care. Some drugs may have variable effects in different racial/ethnic groups.Caucasian / WhiteBlack / African AmericanAmerican Indian / Alaska NativeHispanic / LatinoAsianNative Hawaiian or Other Pacific Islander* Biological GenderMaleFemale* Are you currently pregnant?YesNo If YES, when is your due date? (DD/MM/YYYY) For example, December 25, 2021 is 25/12/2021* Do you have any allergies?YesNo If YES, please list all allergies below: * Preferred Language (e.g. English)* Country / RegionCountry/RegionAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe * Country / Region * Address Line 1 Address Line 2 * City * State / Region * Zip / Postal Code Were you referred by a friend? Enter their Name and Email Address below:* Agree To The TermsI AgreeBy checking the box above, I am indicating that I agree to the Privacy Policy and Terms of Use of the Pill Pals website. In addition, I have read the Electronic Signature Consent Statement, HIPAA Authorization & Disclosure, and Disclaimer pages. Done(Use Cropper to set image and <br/>use mouse scroller for zoom image.) Select Your Payment MethodCredit Card / Debit Card / Google PayPayPalHow you want to pay?Auto Debit PaymentManual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Coupon Discount Amount : , Final Payable Amount: SubmitAlready have an account? Login
