Submit a request

Hi, welcome to Phil. We can help you request a product from the Digihaler^® family of inhalers from your doctor or transfer a current prescription from a local pharmacy

Please complete the following info to help us get started:

I have a prescription for a Digihaler^® product and I would like to transfer to PhilRx.

I have an inhaler that is not a smart inhaler and would like to request a product within the Digihaler^® family.

I don't currently have an inhaler prescription.

Please complete the following info to help us get started:

First and Last Name: This field is required.

Patient Phone Number: This field is required. Please enter the correct phone Number

Patient Email: Please enter the correct email

Patient Date of Birth (MM/DD/YYYY): This field is required. Please enter the date of birth in this format (MM/DD/YYYY).

Digihaler^® choices: This field is required.

Pharmacy Name: This field is required.

Pharmacy phone #: This field is required. Please enter the correct phone Number

Pharmacy fax #: This field is required. Please enter the correct fax Number

Pharmacy address: This field is required.

Rx number (if available):

Doctor Name: This field is required.

Doctor Phone #: This field is required. Please enter the correct phone Number

Doctor Fax #: This field is required. Please enter the correct fax Number

Doctor address: This field is required.

I agree to the Phil Terms and Conditions and allow them to contact my healthcare provider or local pharmacy for this request: https://phil.us/terms/

Please agree to terms and conditions.

Talk to your doctor about prescribing you a Digihaler^® product!