RxEra Prescription Support Pilot Enrollment Request and SMS Opt-In

RxEra by Nexus AI Solutions LLC

This public form requests contact about the RxEra Prescription Support pilot and records optional SMS consent. It is not the medication or prescription intake. SMS consent is separate and is not required to request enrollment or use any available non-SMS service.

Contact Information

Use this form only to request pilot enrollment. Do not enter medication names, prescription details, dates of birth, insurance information, pharmacy records, diagnoses, or other health information. If the pilot can accept you, RxEra Prescription Support will provide an approved secure method for the full onboarding intake.

Full name Email address Mobile phone number

Providing a mobile phone number does not by itself opt you in to SMS messages.

Optional SMS consent By checking this box and providing my mobile phone number, I agree to receive service-related customer care text messages from RxEra Prescription Support about prescription refill support. Messages may include refill timing reminders, refill request prompts, refill submission confirmations, renewal-request updates, refill status updates when available, expected pickup timing when available, and responses to HELP, STOP, and START commands. Message frequency varies based on refill activity. Msg & data rates may apply. Reply STOP to unsubscribe, HELP for help, and START to resume messages. SMS consent is optional and is not required as a condition of purchase, enrollment, or use of any non-SMS service.

RxEra Prescription Support SMS messages are customer-care/service messages only. They are not advertising, sales, lead generation, or promotional marketing.

See the Privacy Policy and Terms and Conditions.