Request Refills

If you are a current customer, use the form below to request refills on your prescription(s).

**If you are a new patient and/or need prescriptions transferred to us, fill out the NEW PATIENT INFO and the TRANSFER MEDICINE forms.**

Be sure to check the bottom of your prescription label to make sure you have refills & the prescription is not expired.

If your medicine does not have refills, we will send a request to your doctor if your doctor accepts refill requests, otherwise you may have to call and request refills.

If you have more than 4 refill numbers, add the rest in the last “notes” field. 

Your cell phone number and cell phone carrier are required for us to send you a text message when your prescriptions are ready.

Be sure to click “SUBMIT” after filling in the information.

We can text you when your prescriptions are ready.

Prescription Information

Your RX number is a SEVEN digit number on the top left corner of your prescription label. 
If needed, you may add additional RX numbers here.