Forms & Payment Instructions
Use the links below to download and complete our most commonly requested forms. For any questions, contact our team at 1-800-659-6609.
Accepted Payment Methods
We accept the following types of payment:
- ACH: Recurring payments auto-drafted on the 10th of each month
- Check: Please make checks payable to Republic Pharmaceuticals
- Credit Cards: American Express, MasterCard & Visa
- Fax Forms To: 1-800-671-9980
- Money Wire: Accepted — contact us for details
What Independent Pharmacies Are Saying
“The setup form was simple, and we were onboarded within 24 hours. It’s rare to find that kind of efficiency.”
— Pharmacy Owner, Pennsylvania
“We use ACH to streamline our payments each month. Republic made it easy and transparent from the beginning.”
— Independent Pharmacist, Arizona
“Their return form is clear and the process is fast. We got our credit quickly without chasing anyone down.”
— Community Pharmacy, Illinois
*Testimonials are illustrative and based on common customer feedback. Names and locations have been changed for privacy.