Please
re-order your prescriptions at least 3 to 4 weeks in advance to ensure you do not run out
of your medication(s).
METHOD 1 - You may phone in your re-orders toll free at 1-877-888-3323
METHOD 2 - Submit
prescription Re-order form by filling out the information fields below:
First Name
Has your shipping address changed?
If Yes, please provide new address info below.
Last Name
Email
Phone Number
Please enter the prescription number(s) located on the top left
hand corner of the label and the name, strength, quantity
and current price of each medication(s).
Rx Number
Medication
Strength
Quantity
Current Price
#1
#2
#3
#4
#5
#6
#7
#8
#9
#10
Have there been any changes to your health or to the
medication(s) you are currently taking?
If yes, please indicate.
Have there been any changes in your credit card
information or payment method?
Please check expiration date on your credit card.
If yes, please indicate.
Additional Information:
Please type in your Full Name to Authorize
this Re-order/Refill
Please enter the prescription number(s) located on the top left
hand corner of the label and the name, strength, quantity
and current price of each medication(s).
Have there been any changes to your health or to the
medication(s) you are currently taking? 
Have there been any changes in your credit card
information or payment method? 
