Medicine Shoppe #1667
302 N Main St
Highlands, TX, 77562
Tel.: (281) 426-3581
Fax.: (281) 426-7054
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.


Rx Number(s)

Numbers only
NO letters or dashes