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: 1-888-635-3817 ( toll free )

Print New Customer Order Form

Print Existing Customer Order Form

*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: 1-888-635-3817 ( toll free ).