Prescription Refills

Prescription Refills
Order Refills 24 Hours a Day

*Indicates required field.

Basic Information:
*First Name:
*Last Name:
*Phone Number:
E-mail Address:
Mailing Address:
City:
State:
Zip Code:

Prescription Information:
*First Refill Number:
Second Refill Number:
Third Refill Number:
Fourth Refill Number:
Fifth Refill Number:

How will you receive your prescription?
Ship it to me I'll pick it up

Payment Information:
Credit Card on file
Have Hazle Compounding contact me by phone for my credit card information
I will contact Hazle Compounding by phone regarding my credit card payment information

Comments or Special Requests

Or refill your prescription by phone 570-454-2958 or 1-800-213-0592
We accept most major credit cards.

DISCLAIMER
Hazle Compounding is a licensed compounding pharmacy that
only engages in compounding in response to a physician's prescription.
A written prescription from a licensed physician is required for compounded medication.
The information on the site is general in nature and is only intended for use as an educational tool.
You should consult your physician or a Hazle Compounding pharmacist if you have any
specific questions relating to the diagnosis and treatment of any health problems.
Information and statements about products and health conditions
have not been evaluated by the Food and Drugs Administration (FDA), nor has
the FDA approved the products to diagnose, cure or prevent disease.