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Fax your Refill Order!

  1. Print off a "Refill Order Form" by clicking on one of the buttons below.
  2. Complete the Refill order form (please print clearly).
  3. Simply Fax us the completed form along with any new prescription(s) to: 1-866-535-0563 ( toll free )

*Note: If you have any problems signing in please call us toll free at 1-888-635-3816. You can add new prescriptions to your refill order and save on shipping! Simple add the new prescription(s) to the refill form and fax us the original prescription(s) using this Fax Coversheet to: 1-866-535-0563 ( toll free ).

Refill Prescription Ordering Methods:

  • Order your refill over the phone.
  • Place your refill order online.
  • Fax us your refill.
If you require any assistance please call us toll free at:

1-888-635-3816 ( toll free )

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