Print and Mail Order Form


To order by mail, please send us:

  • the original written prescription
  • a completed order form (pdf)
  • payment by check, money order or credit card

Be sure to include your Member ID number (check your Cigna HealthCare card) on the order form.

Mail the completed order form, written prescription and method of payment to:

Cigna Tel-Drug
PO Box 1019
Horsham, PA  19044

New prescription orders will not be filled unless we have the completed mail order form and original written prescription. If your order includes a refill request, we will process and ship the refill immediately. New orders will be shipped separately.

Please review the frequently asked questions (FAQs) for more information on the order and delivery process.