To enroll in the LibraRx Direct Reconciliation program, dowload, print and complete our enrollment form.
LibraRxDirect Enrollment Form (20K PDF)

If you have any questions or problems filling out this enrollment form, please contact us at 800-460-1575 option 4, and we will be pleased to assist you.

Mail or fax completed form to LibraRx Direct:

LibraRx Direct
P.O. Box 26546
Overland Park, Kansas 66225

FAX: (913) 661-0297

Upon acceptance of your enrollment form, a pre-populated agreement will be mailed to you for you to sign and return to LibraRx Direct.