📍 9787 SW 72nd St, Miami • Open Mon–Fri 8:30am–6:00pm · Sat 9am–1pm • Free same-day Miami-Dade delivery
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Home/ Surgery Care/ Patient Intake
Surgery patient intake

Your Recovery, Ready to Go

Send us your ID and prescription — we'll have your medications prepared and delivered before surgery day.

Step 1 — Patient identity 1 of 4

Patient information

Enter your details exactly as they appear on your government-issued ID. This is required for prescription processing.

Fields marked * are required. Your information is handled securely under HIPAA.
Personal details
Contact
Government ID

Your ID number is used only for identity verification and is not stored after processing.

Surgery details

Tell us about your procedure so we can prepare the right recovery medications.

Known allergies & current medications

Upload your prescription

Take a clear photo of your surgeon's prescription and upload it here. We'll use it to prepare your medications before surgery day.

✓ Photo, scan, or screenshot all work. Make sure the surgeon's name, medications, and your name are visible.
Prescription photo
📄
Tap to upload or take a photo
JPG, PNG, HEIC or PDF · Max 10 MB
Prescription preview
Don't have the prescription yet?

Review & submit

Confirm your information before sending. A pharmacist will reach out within 1 business day.

By submitting this form you authorize D&D Pharmacy to process your prescription, contact your surgeon if needed, and prepare your medications for the surgery date listed above. Your information is handled under HIPAA.

✓

Intake received

Your information and prescription have been sent to our pharmacy team. A pharmacist will contact you within 1 business day to confirm your order and delivery.

Check your email for a confirmation from D&D Pharmacy.

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What to expect

  • 1Submit this form — takes about 5 minutes.
  • 2A pharmacist reviews your Rx and contacts you within 1 business day.
  • 3We prepare your medications and deliver them before surgery day.
  • 4We follow up during your recovery.

Questions?

Call or text us — a real pharmacist picks up.

(786) 558-0702 Mon–Fri 8:30am–6:00pm · Sat 9am–1pm

Privacy & security

This form is transmitted over an encrypted HTTPS connection. Your health information is handled under HIPAA and Florida patient privacy law. Your ID number is used for verification only and is not retained after processing.