Simply Fill Out The Form Below

Without the Hassle, Without the Wait. All you have to do is put in your RX number(s) along with your name & contact info. We’ll receive your submission immediately via fax & will get your refill ready right away. Then, you can pick up your refill whenever you desire. If you have any additional comments or questions, please fill out a Contact form. If you’re a nursing home and need to submit a refill or prescription, please use our portal: Thank you!