Complete the form below to refill your prescription from the UHS Pharmacy.
Online ordering is only for refills of prescriptions from the UHS Pharmacy. New prescriptions must be delivered to the pharmacy in person or requested by your healthcare provider.
The pharmacy can only fill prescriptions written for patients who are currently registered and receiving services at UHS.
You must have refills remaining on your prescription to use online ordering. Check the label on your medication; if no refills remain, contact your UHS provider for a prescription. Not sure how to read the label? Click here for a sample.
Please allow one business day for your request to be processed. Refills are subject to medication availability. All personal information submitted on this form is covered by UHS' privacy practices.