Patient Requested Refills Only | Lake Elmo Compound Pharmacy

Patient Only
Refills

For VET CLINIC refills, please submit here. All other refills proceed on this form!

Please submit only one refill request per medication.
Submitting multiple requests through different channels (website, pharmacy, voicemail, etc.) causes delays and may extend turnaround time. Thank you for your cooperation.

Facebook

This field is for validation purposes and should be left unchanged.

Patient Name(Required)

Pet Name

Date of birth(Required)

If requesting a refill for your pet, and DOB is unknown, please enter your own DOB

Email(Required)

List Refills(Required)

Prescription Number

Click the plus icon to add another row

Would you like a 90 day supply on your medications, if the prescription allows?

Would you like reminders that it is almost time to refill you medications?

Choose one:(Required)

Store pickup

Ship to address

You will receive a text message when your prescription has been completed and ready for pick up.

Shipping Options(Required)

If the medication requires refrigeration, it will automatically be Cold Shipping

Shipping Address(Required)

Street Address Address Line 2 City State ZIP Code

Comments or Special Requests

We securely process prescription payments using the credit card on file. If no card is available, you’ll receive a text and/or email with a secure link to complete payment.

Please note: no prescriptions will be filled until payment is received.

Patient OnlyRefills

We securely process prescription payments using the credit card on file. If no card is available, you’ll receive a text and/or email with a secure link to complete payment. Please note: no prescriptions will be filled until payment is received.

Patient Only
Refills

We securely process prescription payments using the credit card on file. If no card is available, you’ll receive a text and/or email with a secure link to complete payment.

Please note: no prescriptions will be filled until payment is received.