Enrolling with miRx is easy.  Simply fill out the enrollment form, and submit via email to miRx@ebms.com.  If you have any questions, please don't hesitate to contact us at 866.894.1496.

MiRx Enrollment Form

Prescription Transfer Form

993 S 24th Street West • Billings, MT 59102

P 406.869.6551 T 866.894.1496 F 406.869.6552

miRx@ebms.com • www.ebms.com

Last Updated: 3/31/2016