Records & Forms

Cancer Settlements Records & Forms

To assist with your collection of the information we need to optimize your Claim, these forms will help you access your information from major pharmacies.

When requesting your records, you do not need to tell the pharmacy the reason you want them. It's your business and all they need to know is that you want a copy for your own records.

Wal-Mart - Patient Access Request

Rite Aid - Patient Access Request

Walgreens - Patient Access Request

CVS - Patient Access Request

Costco - Patient Access Request

Safeway - Patient Access Request

Meijer - Patient Access Request