Member Forms

Listed below are helpful forms, which may be downloaded and printed.

Complete forms should be mailed to:

Windsor Rx
Attn: Customer Service
7100 Commerce Way
Suite 285
Brentwood, TN 37027

Or faxed to:
Customer Service – 615-782-7828

Authorization to Release Protected Health Information Form (PDF)

Individual Credit Card Form (PDF)

Individual Account Bank Draft Form (PDF)