• Membership Form

  • MEMBERSHIP SELECTION (see chart below for more details) I wish to sign up for*

  • STANDARD/ INDIVIDUAL MEMBERSHIP • $50/year This membership is best for individuals looking to access our pricing model's convenient monthly fills, with minimal need for pharmacist consultation or review.

     

    FAMILY MEMBERSHIP • $75/year This membership is best for families looking to take advantage of our pricing model, who would like the convenience of single household deliveries, or pet medication savings.

  • Membership available to RI, MA, and CT patients. More states to come!

  • SPECIAL PHARMACY SERVICES

  • Check any services you are interested in, or if not currently available, would be interested in the future.*

  • PAYMENT INFORMATION

  • Preferred Payment Method*
  • How would you like to be notified when prescriptions are ready?*
  • Would you like to receive text message updates regarding in-store events or promotions?*
  • Format: (000) 000-0000.

  • *By providing my phone number, I consent to receive marketing and promotional text messages from Compass Core Pharmacy at the phone number provided. I understand that these messages may include special offers, promotions, product updates, and other relevant information. I acknowledge that: (a) message frequency may vary; (b) standard message and data rates may apply; and (c) my consent is not a condition of purchase. I can opt out at any time by replying “STOP” to any message received. For more information on how we handle your data, please review our Privacy Policy in store or at compasscorerx.com.

  • CONSENT & SIGNATURE

  • By signing below, I confirm that the information provided is accurate. I authorize Compass Core Pharmacy to obtain my prescription history, manage my medications, and provide requested pharmacy services.

  • Date*
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  • Select Membership

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    Standard Membership. This membership is best for individuals looking to access our pricing model’s convenient monthly fills, with minimal need for pharmacist consultation or review.
    Standard Membership

    This membership is best for individuals looking to access our pricing model’s convenient monthly fills, with minimal need for pharmacist consultation or review.

    $50$50 for each year
      
    Family Membership. This membership is best for families looking to take advantage of our pricing model, who would like the convenience of single household deliveries, or pet medication savings.
    Family Membership

    This membership is best for families looking to take advantage of our pricing model, who would like the convenience of single household deliveries, or pet medication savings.

    $75$75 for each year
      
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