Order Refills

Order Refills 2017-10-10T12:34:48+00:00

 

 

 

This form is for refills picked up at the clinic ONLY.   To transfer refills to a pharmacy, call us at 406-587-0681 during office hours. 

We require 1 business day to process your order.  If someone else is picking up for you, please include their name in the message of your order.   

Click here for hours and holiday closure information.

 

 

 

Your Full Name *

Your Email *

Phone *

Date Of Birth * (mm/dd/yyyy)

Quantity *

Message

 

Email address must be valid.  This refill message is secure and encrypted for your privacy.