Refill Prescriptions Online

Refill Your Prescriptions
Please verify your information below and submit your prescription refill request. We will process your request shortly and will contact you if we have any questions.

Please Note: Zale Drugs will dispense prescription drugs only after receiving a valid prescription in accordance with U.S. federal law.

* Required
 

Your Personal Information

  * First Name: * Last Name:
  Street Address: City:
  * State: Zip Code:
  * Phone: ( )   * Email Address:
 

Prescriptions Requested

Please enter the prescription number, drug name and the first name of the person the refill is for. Add up to ten prescriptions at a time.

  RX # Drug Name Patient
First Name
Compound?
1
2
3
4
5
6
7
8
9
10
 
 
 

Pick Up Prescriptions Schedule

  Pick up Date: Time:
 

Special Instructions