Refill Prescriptions

To order a prescription refill online, please complete the form below. All internet orders are retrieved and processed during normal business hours, Monday through Friday, 8a.m. - 5p.m. Central Time. As always, there is no charge to you for shipping your medications.

First Name:	*
Last Name:	*
Rx Number(s):	* enter one Rx number per line and hit enter
Date Needed:	* ex:  mm/dd/yyyy
Phone:	*
Please enter any comments below:
Please indicate shipping address if different from your home address:
Address:
City, State, Zip:
E-mail:
By entering your E-mail address, you are authorizing Amber Pharmacy to send you periodic updates via E-mail.
* Required fields

OTHER WAYS TO ORDER REFILL PRESCRIPTIONS AT AMBER PHARMACY!

Call toll-free at 1-888-370-1724

E-mail us at refill@amberpharmacy.com and provide your name, your Rx number or drug name, the refill quantity and date needed. (If you do not receive an email acknowledgement for an order you place by email to: refill@amberpharmacy.com within 24 hours, please call us toll-free at 1-888-370-1724 to confirm that your order was received.)

Fax us at 402-896-3774

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