Refill Request ONLINE

Refill Request


Please complete the following short form to request refills from our stores. If you are unsure of the prescription number(s), kindly provide ONLY THE FIRST THREE letters of the drug(s) to ensure privacy. Please note that it may take one working day to process and have your prescription(s) ready for pickup, if possible.



Once you have filled out the form, click the "Submit" button to send your refill request.


Thank you for choosing Easy Pharmacy & Surgicals. We will process your refill request promptly and notify you when your prescription(s) are ready for pickup or delivery. If we have any questions or require further information, we will reach out to you using the provided contact details.