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Refill Request  

As part of our committment to excellent customer service, current patients with prescriptions at The Pharmacy may utilize this automated refill service. You may enter up to five refill requests per submission. If you have new prescription insurance information, please call us prior to submitting this request. If we have any questions we will contact you using the information you provide below.

If you have any questions or require immediate assistance, do not hesitate to phone our store at (607) 798-0343.

(* Required information.)

Name:(First & Last) *

Prescription 1 - 7 digit RX number: *

Prescription 2 - 7 digit RX number:

Prescription 3 - 7 digit RX number:

Prescription 4 - 7 digit RX number:

Prescription 5 - 7 digit RX number:

When will you pick up this order? *

Email Address:

Phone Number: * Home Work Cell

Please enter any questions or comments for the pharmacist here.

Please press submit only once.

Depending on your internet service provider you may experience a 3-5 second delay to process your request.
 
© 2007-2008 The Pharmacy • 711 Main Street (Corner of Main St. & Oakdale Rd.) •Johnson City, New York 13790
Hours: Monday-Friday 8:00am - 6:00pm - Call us for Special/Major Holiday Hours
(607) 754-SAVE or (607) 798-0343 • Fax (607) 798-1439