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Prescription Refill Service

Please use the form below to refill your prescriptions online. Multiple prescription numbers may be entered separated by a space or comma. We'll use the contact information you provide for any questions. If you'd like additional items with your refill, use the add-on items section below.

Store Location
Prescription Numbers
Patient Name
Contact Phone
Delivery Preference In-Store Pickup 
Drive-Thru/Curbside * 
Mail/Local Delivery ** 
Optional Add-On Items
 
 

* Curbside pickup available at stores not equipped with a drive-thru window.
** Local and/or daily delivery not available at all locations. Please call store directly for delivery clarification.

Conditions and Privacy

This application is for requesting refills of prescriptions already filled at one of our stores. State law requires that all new prescriptions be delivered in person or be phoned in by your doctor. We gladly welcome transfers of prescriptions from other pharmacies. Please call to have your prescription transferred at no cost to you.

Please allow 60 minutes for your online refill request to be processed and ready for pick up.

If anything about your medical condition or insurance has changed, please call your pharmacy. Your health is important to us. By providing us this information before we fill your prescription you can avoid delays and unnecessary side effects.

All personal information submitted on this form will be held in strict confidence and is covered by our Privacy Policy. Please read it carefully before submitting.