Chiron Compounding Pharmacy Inc.

* Enter Rx Number

* Patient Name Please enter patient name as it appears on the label.

* Email Address You will receive a confirmation email from a customer service representative.

* Can we refill the prescription the exact same way as your last refill? If you would like to change the quantity or flavour, please contact a customer service representative.

Yes
No

* Please indicate if you would like Delivery or Pick-Up. If Delivery - Please request a delivery date and indicate delivery address. Note: Someone must be present to sign for this package since it contains a prescription.
If Pick-Up - Please indicate a date and time.

* Can we use the Credit Card we have on file? If your credit card information has changed please contact a customer service representative.

Yes
No

Refill Prescription for Humans