Please complete the following form to request a refill. Please refill with the same quantity as previous prescription(s)Please check with the doctor to see if the prescription can be filled with a larger quantityWhen would you like your medication prepared for pick-up? MondayTuesdayWednesdayThursdayFridaySaturday 8-12 pm12-6 pm **(M-F only)** We will review your refill request and confirm its approval as soon as possible. Please note that e-mail is not continually monitored, if this is an urgent request or you don't hear from us within 24-48 hours, please call our office directly at 434-525-2111. Online refill requests can take up to 24 hours to be received, be approved and filled. Thank you for your patience. Form submitted successfully! You are missing required fields. Dynamic Error Description There was an error processing this form.