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RX Prescriptions Refill

To refill prescription(s) online, simply complete the Refill Request form below (e-mail address is optional).

Personal Information



Last name must be entered exactly as it appears on the Prescription Label.

Number where you can be reached if the Pharmacist has a question.
 

Required only if you wish to receive an Email confiming your order was received by the Pharmacy. If you have not entered an Email address, please contact the pharmacy to confirm your prescription has been received.

Prescription Information

Please enter the prescription number(s) you wish to refill at this time. This number is located on your prescription label (see example). All Prescriptions entered must match the Last Name as entered above.

Kinburn Pharmasave - Prescription InformationClick to enlarge
Pharmacy Location
Please Note: Prescription numbers are location specific. A prescription, when filled at one store, cannot be refilled at another location online via this Rx Refill Form.  If you do wish to have your refill processed at another location, please feel free to call the store during open hours to have your order filled.








 
Would you like to:
Pickup your prescription
Have your prescription delivered to you