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Refill Request

NOTICE


This system can only be used to place a REFILL request for prescriptions PREVIOUSLY OBTAINED through the UVA Pharmacy Network.

Effective May 16th, Summer Semester hours will take effect at the Student Pharmacy. It will be open Monday through Friday from 8:30 a.m. until 4:30 p.m. and closed from Noon to 12:45 p.m. for lunch.

Click here for help filling out this form

Medical Record Number


 

Prescription(s) to refill

Enter your full prescription number, excluding the dashes.


RX #1


RX #2


RX #3


RX #4


RX #5


RX #6


RX #7


RX #8


RX #9


Please note it may take up to one minute for your request to be processed. Please do not press the Submit button more than once.