Rx Refill

Fill out the information below to refill your medication(s). By submitting your refill request you are agreeing to Geritom’s HIPAA Notice of Privacy Practices. Please note this is for refills only, for new orders please contact the pharmacy at (952) 854-1190. Our site is SSL secured and you will receive confirmation of your refill request.

For multiple Rx, separate with a semi-colon. Ex: 98798; 23456; 45...