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Please Read the Terms and Conditions. This site allows you to request a refill of a prescription originally dispensed by Medlandia pharmacy¬† and which has refills remaining and can be refilled by law. Your request for a prescription refill will be transmitted to Medlandia Pharmacy¬† Once the pharmacy has received the request it will be handled in the same manner as all refill requests, at all times being subject to the dispensing pharmacist’s professional judgement and responsibilities.

By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, you’re entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.

The information provided by you on this web site is the minimum amount of personal information necessary to identify the prescription and the patient and to process the refill request. In order to properly dispense a prescription and for the patient’s health and safety, the pharmacy or the patient may have to contact the physician (or the prescribing professional) to discuss the refill request and the patient’s medication history and medical conditions. In the course of such discussions the patient’s personal health information may be disclosed. The receipt of a refill request shall be deemed consent to such disclosure and use of the patient’s personal information.

If the patient has health insurance coverage for his/her prescriptions, information about the prescription will be transferred to such health insurer and they may have access to the patient’s personal health information in order to properly process the benefits. The patient’s consent to this disclosure of personal health information to such health insurer is deemed by the request for payment or reimbursement for the prescription to such health insurer and/or the provision of the details of the patient’s health insurance.

Please note that as with all technologies, there may be interruptions or technical failures. Medlandia Pharmacy expressly denies any liability for technical failures, incomplete, scrambled or delayed transmissions and/or technical inaccuracies. Please consult your Medlandia Pharmacist with any questions or concerns.

Refill Form