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Online
Prescription
Refills

Simply complete the form below and press the "Send" button to submit your refill request. Fields in red must be completed. To protect your privacy, Thomas Drug Store will not distribute your phone number or email adress. They will only be used to confirm your identity and to contact you should any problems arise concerning your refill.

Your Full Name:
Email Address:
Phone:

Prescription Numbers:

Your prescription number is a 7-digit number found on your prescription bottle. You can enter up to 5 prescription numbers, 1 in each box at right.

 





Special Instructions:

Pickup or Delivery:

Will you pickup your prescriptions at Thomas Drug Store or would you like them delivered to your home?



Pickup Time:

When will you be in Thomas Drug Store to pickup your prescriptions?


After

Delivery Instructions:

If you have chosen to have your prescriptions delivered, please provide your address and any helpful directions.

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F.B. Thomas Drug Store, Inc. • 327 Main Street, Meyersdale, Pennsylvania 15552
Telephone (814) 634-8614 • Fax (814) 634-0827
This site is maintained by Historitecture, L.L.C. (c) 2005 F.B. Thomas Drug Store, Inc.