We appreciate your continued confidence in using Pharmacy Compounding Solutions for your prescription refills.  Please complete all required fields on the form below.  We will process your refill during regular business hours.  You will be notified by email that we have received your prescription refill request and when we ship your prescription. If there are no refills remaining on your prescription,  we will contact your physician for refill authorization.
Refill Contact Information

First Name:

Last Name:

Phone Number:

Email Address:

Rx Number #1:

(Example: 031234-678910)

Rx Number #2:

Rx Number #3:

Rx Number #4:

We can only refill prescriptions that were filled by Pharmacy Compounding Solutions within the past 12 months. Prescriptions expire 12 months after they are written. If you need help finding a prescription number, please call us at (253) 564-2323.

Your Date of Birth: (required)

Date Format:MM/DD/YYYY


Pharmacy Compounding Solutions values your privacy. Your information will not be shared, rented, or sold to others.