Rx Refills

To submit your Rx refills OTHER THAN COMPOUNDS, please use the form below. To start, please fill in the form using the Rx number or if you don’t have the number, the medication name for each. Either way we will prepare your refills for you as we always have, the choice is yours.

NOT FOR COMPOUNDED RXS, Click HERE to order compounded refills

Who Is This Prescription For?
Name*
First Last
Phone*
Email Address
Medications Needed
Entering Refill Information
If you have the refill Rx#, it is not required to enter the Drug Name, although you still may if you would like.
Rx Number 1:
Enter your Rx number from your prescription bottle.
Name of Drug 1:
If no Rx number, enter the medication name.
Rx Number 2:
Name of Drug 2:
Rx Number 3:
Name of Drug 3:
Rx Number 4:
Name of Drug 4:
Rx Number 5:
Name of Drug 5:
Rx Number 6:
Name of Drug 6:
Pick-Up Information
Pickup, Delivery or Shipping*
Time you need this by*
Would you like us to notify you when your prescriptions are ready?
- No, Thank You
- Yes, via Telephone
- Yes, via Text Message (cell # should be in phone above)
Message or Instructions To The Pharmacy
CAPTCHA

Who Is This Prescription For?

Medications Needed

Pick-Up Information

Our Location

1 N. Central Ave
Canonsburg, PA 15317

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