Cottonwood Pharmacy
20635 Gas Point Rd
Cottonwood, CA, 96022
Tel.: (530) 347-3721
Fax.: (530) 347-0456
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