To fill prescription online, please take a photo of your prescription slip and complete the form below.
Pick or take a photo*
Full Name* Name must be entered exactly as it appears on the Prescription Label.
Phone Number*
Select the date you would like to pick up your prescription. While your medication(s) may be ready earlier, please allow up to 24 hours for us to prepare your prescription (or longer, if a refill is requested the day before an observed statutory holiday);
Pickup date*
Special Requests/Instructions Do NOT include any personal health or billing/credit card information.
Privacy Policy* I have read and I agree with Privacy Policy and Terms of Use. Please review your request before submitting.
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