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Disclaimer

Please read and accept our privacy policy before proceeding.
By clicking submit: You agree to receive SMS messages from QRX Pharmacy. regarding your inquiry and our services. Message frequency may vary. Message and data rates may apply. You can opt out at any time by replying STOP. For assistance or more information, reply HELP. Your information will be handled in accordance with our Privacy Policy.”” right below your webform.
SMS SERVICE: You expressly consent to receive informational and updated SMS messages from QRX Pharmacy regarding your inquiries. You understand that the frequency of these messages may vary.
No Third-Party Sharing: QRX Pharmacy will not share any of your information or consent with any third party for marketing or promotional purposes. This includes affiliates, third-party companies, or any other entities. Additionally, your information will not be shared with any third parties for any reason other than sending you requested information or updates.
Data Rates: Standard message or data rates may apply from your service provider for receiving messages
OPT-OUT: You can opt-out of receiving any future messages from QRX Pharmacy by simply replying “STOP” to any message you receive.
NOTE: Refer to our privacy policy for more details on your data privacy and our data practices.
Privacy Policy.You can also contact us for more assistance and concerns.

Refill Your Prescription (Refill RX)

Please enter your full name.
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Please enter your phone number including area code.
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(Optional) Enter your prescription number if you have it.
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Please enter the name of the medication you need a refill for.
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Preferred Pickup or Delivery Option
Choose your preferred method to receive the medication.
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(Optional) Add any additional notes or instructions here.