Refill Your Prescriptions

We will notify you when they are ready

Prescription Refill Request Disclaimer

This online prescription refill request service is offered as a convenience to our patients. Submitting a refill request online does not guarantee that your prescription will be refilled. All refill requests are subject to pharmacist review and approval, and must comply with all applicable state and federal laws and regulations.

Please allow [Number] business days for processing your refill request. We will contact you if we have any questions or require additional information. If you do not hear from us within [Number] business days, please contact the pharmacy directly at [Phone Number].

Important Information:

  • This form is for refill requests only. New prescriptions require an appointment with your healthcare provider.

  • Controlled substances cannot be refilled online. Please contact the pharmacy directly for information regarding refills of controlled substances.

  • Your insurance information will be verified. Any co-pays or deductibles will be due at the time of pickup.

  • We are not responsible for delays in processing due to incorrect or incomplete information provided by you.Please ensure all information is accurate and up-to-date.

  • By submitting this form, you acknowledge and agree to the terms of this disclaimer.

If you are experiencing a medical emergency, please do not use this online service. Call 911 or proceed to the nearest emergency room.