Refills

 

 

Fill out the form below with your prescription information, and they’ll be ready for pickup or delivery in no time.

All provided information is confidential.

Please allow 1-2 business days for compound refills.

 

 

SUBMIT

First Name*

This field is required.

Thank You!

The form has been successfully sent.

Last Name*

This field is required.

Email*

This field is required.

Birthdate (mm/dd/yy)*

This field is required.

RX Numbers (6 digits each)*

This field is required.

Pick up, Delivery, or Mail*

This field is required.

Location*

This field is required.

Day Contact Number*

This field is required.

If Mail or Delivery:

This field is required.

Shipping fee may apply. At this time, we are only able to ship within the state of Alabama. 

Decatur City Limits for Delivery

By submitting this form, you are giving us permission to use the payment form we have on file for you. If we do not have payment information on file for you, we will contact you at the phone number provided above. Prescription medications will not be delivered/mailed without making payment arrangements.

Comments:

This field is required.

CONTACT  US

2422-J Danville Road SW
Decatur, AL 35603
Ph: 256.353.1121
info@thepillboxofdecatur.com

© 2013-2016 The Pill Box Pharmacy and Zellus Marketing  

Disclaimer: A prescription from a licensed practitioner is required for compounded medications.  Privacy Policy

.

SUBMIT

First Name*

This field is required.

Thank You!

The form has been successfully sent.

Last Name*

This field is required.

Email*

This field is required.

Birthdate (mm/dd/yy)*

This field is required.

RX Numbers (6 digits each)*

This field is required.

Pick up, Delivery, or Mail*

This field is required.

Location*

This field is required.

Day Contact Number*

This field is required.

If Mail or Delivery:

This field is required.

Shipping fee may apply. At this time, we are only able to ship within the state of Alabama. 

Decatur City Limits for Delivery

By submitting this form, you are giving us permission to use the payment form we have on file for you. If we do not have payment information on file for you, we will contact you at the phone number provided above. Prescription medications will not be delivered/mailed without making payment arrangements.

Comments:

This field is required.

Coupon codes may not be used toward prescription costs or copays, only our online store.

 

2422-J Danville Road SW
Decatur, AL 35603
Ph: 256.353.1121
info@thepillboxofdecatur.com

2422-J Danville Rd SW
Decatur, AL 35603
Ph: 256.353.1121