CenterWell Pharmacy, Inc.
The following documents are required by CenterWell Pharmacy, Inc. as a condition of dispensing medications under the ApalyRx program. Your acceptance of the Apaly Health Inc. Terms of Use constitutes your acceptance of these forms for any prescriptions routed to CenterWell Pharmacy.
These documents are incorporated by reference into the ApalyRx Terms of Use and the Apaly Health Inc. HIPAA Authorization. If a CenterWell Pharmacy form conflicts with the Apaly Health HIPAA Authorization on a matter specific to CenterWell Pharmacy's program, the CenterWell Pharmacy form governs for that matter.
HIPAA Authorization
Last updated: March 31, 2026
Authorization to use and disclose medical information to CenterWell Pharmacy, Inc. and pharmaceutical manufacturers for patient support services.
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Patient Consent and Acknowledgement
Last updated: March 31, 2026
Consent to prescription fulfillment by CenterWell Pharmacy and acknowledgment of government program restrictions.
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