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 accept prescriptions written by UHS providers and credentialed staff. If you have ongoing prescriptions that you’ll want to fill at the UHS Pharmacy, schedule an appointment with a UHS provider, who can coordinate your care while you’re at school.
- You must have refills remaining on your prescription to use online ordering. Check the label on your medication; if no refills remain, you must 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 availability of medication.
- 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.
