To serve you even better, we’re moving to a new software system. Thanks for your understanding and patience while we make this change!
You can login to access your prescriptions. If you do not see your profile, please re-add your account.

New Patient

We would love the opportunity to serve as your trusted prescription provider.
Please fill out the form below and we will take it from here!

First Name

Last Name

Address

City

State

Zip Code

Email Address

Phone Number

Birth Date (XX/XX/XXXX)

Alternate Contact Name

Alternate Contact Phone Number

Allergies

Optional Prescription Information

Auto Refill My Scripts

Send Text Notifications

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Previous Pharmacy Name

Previous Pharmacy Phone Number

Rx Number

Medication Name and Strength

Rx Number

Medication Name and Strength

Rx Number

Medication Name and Strength

Rx Number

Medication Name and Strength

Message to Pharmacist

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Contact Us

Foster Drug of Mocksville
495 Valley Road, Mocksville, NC 27028
(336) 751-2141 - (336) 751-7974