Refills

You can now request refills online. Requests are usually ready within one business day. If there is a problem regarding your refill, we will attempt to contact you by the e-mail address and/or phone number you provide below. Refills requested on weekends may require one extra business day to fill.

NOTE: If your prescription is out of valid refills, please allow up to 72 hours for your prescriber to approve or decline your refill request. Please allow extra time during holidays since prescribers may have varied hours of operation.

Please fill in all information so we can provide the best service possible. All information is strictly confidential and submitted via a secure connection.

First Name:*	M.I.:*	Last Name:*
Address Line 1:*		Address Line 2:
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Email:*
Phone:*	Date of Birth:* MM/DD/YYYY	Alternative Phone:
Prescription Number (1):		Medication / Prescription Name (1):
Prescription Number (2):		Medication / Prescription Name (2):
Prescription Number (3):		Medication / Prescription Name (3):
Prescription Number (4):		Medication / Prescription Name (4):
Prescription Number (5):		Medication / Prescription Name (5):
Prescription Number (6):		Medication / Prescription Name (6):
Prescription Number (7):		Medication / Prescription Name (7):
Prescription Number (8):		Medication / Prescription Name (8):
Prescription Number (9):		Medication / Prescription Name (9):
Prescription Number (10):		Medication / Prescription Name (10):
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1840 Mesquite Ave. Suite E. Lake Havasu City, AZ 86403 • Call Us at 928.855.0106

Lake Havasu City's only local, independent pharmacy facility. We strongly believe in keeping it local - supporting and promoting Lake Havasu's economy through other small businesses. Dollars spent at corporately owned businesses go directly to corporate headquarters. Dollars spent at local businesses stimulate our local economy. We also give back to our community through local charitable organizations, non-profits, fundraisers, and youth programs.

Caring for you and your loved ones since 1980!

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