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Since 1972

COURTER FINANCIAL SERVICES, LLC

If you would prefer to download our fill-in PDF file to update your medication list, please click the button below. Once completed, you can fax, email, mail, or personally deliver the list at your earliest convenience.

MEDICARE Rx UPDATE

Thank you for updating your Medicare covered Prescription drug list for the upcoming plan year!


Please use the following form to change the dosage or frequency of an existing medication or to provide the name, dosage, frequency and type of a new medication.


If you have additional changes to be made, please click submit and you'll be redirected to a new blank form where you can make the remaining changes.


If your contact information has changed, please contact our office so that we may update our records.


Thank you,

Justin Doherty

Do you receive assistance with your Rx costs?*
Would you be willing to change pharmacies in order to save money?*
Would you be interested in using a Mail Order Pharmacy service?*
Do you need to report any changes to your list of medications? (If you do not need to update your medications or you do not take any medications, please mark the applicable response and scroll to the bottom of the page and click “Submit”.)*
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Thank you for contacting us. We will get back to you as soon as possible

UPCOMING EVENTS:

Life Insurance Awareness Month

Wednesday Sep 1 - Thursday Sep 30

*Halloween

Sunday, Oct 31 All Day

Christmas Eve

Friday, Dec 24 All Day

MERRY CHRISTMAS!!!

Saturday, Dec 25 All Day

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