Online Prescription

Complete the form below to refill your prescription from the UHS Pharmacy.

Important:

Online ordering is only your healthcare provider. 

The pharmacy can only fill prescriptions receiving services at UHS. 

You must have refills 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.






(Click here for a sample)