Prescription Refill Form

Refill your prescription quickly and easily by email! Simply fill out the form below. Items with an * must be completed for your order to go through properly.

After successfully completing the form, you should see a confirmation message. If you do not see this message, your refill request may not have gone through. Please send an email to refill@hdrx.com with the subject “REFILL” along with all information.

Thank you.






1 month
2 months
3 months





Pickup: 48 hours (2 business days)
US Priority Mail: (3-5 business days)
UPS Ground: (1-2 business days)

Other delivery options available, prices vary, please contact us for more information (248-489-1573).

The privacy of your health information is important to us. We will never share your information with unauthorized third parties. To review/print our patient privacy policy, click here



Note:Shipping charges will automatically be charged to your account based
upon shipping method selected. If no method is selected, prescription
will be sent via US Mail.