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Expanding
Access
(877) 562-8577
Top Menu
Prescription Refill
Provider Login
Main navigation
Products
Drug Catalog
Men’s Health
Women’s Health
Dermatology
Hormone Replacement
Weight Management
IV Therapy
Fertility
Resources
Prescription Refill
Careers
Licensure
About Us
Quality
Uniformed Support
Knowledge Center
Notices
FAQ
Contact
Refill Request
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Patient Information
First Name
Last Name
Date of Birth
Phone
Credit Card on File (Last 4 Digits)
Expiration Date
Enter Rx Numbers
Prescription #1
Prescription #2
Prescription #3
Shipping Details
Email
Shipping Address
Address
Address 2
City
- Select -
Alabama
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Utah
Vermont
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Washington
West Virginia
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State
Zip
Shipping Method
2 Day Shipping (*15.00)
1 Day Shipping (*33.00)
Patient Pickup (Free)
Cold shipping will default to 1 day shipping at *$41.00
*Ak/HI/PR/Guam price apply: 1 Day - $35.00, 2 Day - $50.00 and Cold - $58.00
Signature Confirmation
Add signature
Waive signature
Any orders that contain a controlled substance or have a total cost that exceeds $100 requires a signature at the time of delivery. If the waive signature option is selected, Empower Pharmacy will not be held financially responsible for your order if the package is lost or stolen.
Additional Notes
I acknowledge all of the information provided above is correct and I authorize Empower Pharmacy to process my refill and charge my credit card.
Most refill orders are processed within 7 business days of the request
Where Do I Find My Rx Number?
Please find your Empower Pharmacy Rx Number on prescription label above your name.