Refill Prescriptions

To request a prescription refill, please enter your prescription numbers below.

Please check that your prescription has refills remaining and has not expired:

• Controlled substance prescriptions expire 6 months from the written date,
• All other non-controlled substance prescriptions expire 12 months from the written date.

If your prescription does not have any refills left, we highly recommend that you contact your physician and request additional refills.

If your prescription is a special-order medication, allow one or two business days for us to order it for you.

Prescriptions requested online after 5:00 PM will be available the following business day.

If you have any questions or concerns, please call (845) 887 – 3030.

Refill Request

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Patient Information

First Name *

Last Name *

Date of Birth *

Call-Back Number

Prescription Request

Please use one form field for each prescription number.

Refill #1

Refill #2

Refill #3

Refill #4

Refill #5

Refill #6

Refill #7

Refill #8

Refill #9

Refill #10

Preferred pick up time

As soon a possible (within 30 to 60 minutes)

On a future dateOn a future date

Notes or comments

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