Prescription Refill Request
Complete the form below to refill your prescription from the UHS Pharmacy.
Important:
- 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 UHS 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.
- If you have questions or concerns about your prescription, or if there are changes to your personal information or insurance coverage, call the UHS Pharmacy, (413) 577-5030.
- All personal information submitted on this form is covered by UHS’ privacy practices.
