Download Medical Forms | Resources | Moore Medical Online Catalog

Forms You May Need

Download the forms by clicking the .pdf symbol next to the form. Follow the directions on each of the forms on how to submit back to Moore Medical.

  • PDF
    Prescription Drug Authorization Form

    In order to purchase prescription pharmaceuticals from Moore Medical, please complete this form and email or fax back to us.

  • PDF
    Product Order Form

    To order products from us you may fill out this order form then fax to: 800.944.6667 24 Hours a Day/ 7 Days a Week, or mail a copy to: Moore Medical LLC, PO Box 4066, Farmington, CT 06034-4066

  • PDF
    Credit Application Form

    To open a Moore Medical line of credit please download this credit application and complete, then fax to: 860.826.3767 or mail documents to: Moore Medical LLC, PO Box 4066, Farmington, CT 06034-4066

  • PDF
    Authorization to Purchase - Public Sector

    For public sector organizations only (i.e. Government, Corrections and Schools). Complete and return this form to confirm a request to open an account for your organization

  • PDF
    Prescription Drug Return Authorization Form

    All requests to return prescription drugs must be approved by Customer Support within 7 days of invoice and the product(s) returned to us within 15 days accompanied by this signed form.

  • PDF
    Florida Sole Proprietor Letter

    For Florida customers only. This form is needed to determine if a customer is a Sole Proprietor. If the customer is not a Sole Proprietor, an HCCE permit is required.

  • PDF
    Ohio Sole Proprietor Letter

    For Ohio customers only. This form is needed to determine if a customer is a Sole Proprietor. If the customer is not a Sole Proprietor, a Terminal Distributor of Dangerous Drugs (TDDD) license is required.


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