top of page


Use this form to submit non-urgent refill requests to the pharmacy.

Prescriptions that do not have refills or have expired will need to have provider's approval before they can be filled. (Refer to bottom left of prescription label to see if you have refills)

If you have not heard from the pharmacy within 72 business hours, please call 503-234-3488 to speak with a staff member.

Your request has been sent to the pharmacy.

bottom of page