Kanab United Drug
176 W Center St
Kanab, UT, 84741
Tel.: (435) 644-2418
Fax.: (435) 644-2057
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