Medicine Shoppe #1367
333 S E. 7th Avenue, Ste 1500
Hillsboro, OR, 97123
Tel.: (503) 640-4433
Fax.: (503) 693-2975
Request a refill for your medication(s)
Please note that this form allows you to submit up to 5 prescriptions for refill. If you would like to submit more than 5 prescriptions for refill, please complete additional submission forms.

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Rx Number(s)

Numbers only
NO letters or dashes