Patient Refill

We will be closed on Friday, July 4th in observance of Independence Day

* REQUIRED INFORMATION
YOUR INFORMATION
NAME*
First Last
DATE OF BIRTH*
MM slash DD slash YYYY
EMAIL ADDRESS*
DAYTIME PHONE*
ADDRESS*
Street Address City State / Province / Region ZIP / Postal Code Country
WOULD YOU LIKE YOUR MEDICATION(S) SHIPPED? NOTE: WE DO NOT SHIP TO A PO BOX.
SHIPPING ADDRESS
Street Address City State / Province / Region ZIP / Postal Code Country
PRESCRIPTION NUMBERS
1ST REFILL*
2ND REFILL
3RD REFILL
4TH REFILL
5TH REFILL
DO YOU NEED ALL INJECTION SUPPLIES FOR ALL MEDICATIONS?
- Yes
- No
PLEASE SPECIFY WHAT INJECTION SUPPLIES YOU NEED.
COMMENTS OR SPECIAL INSTRUCTIONS
Recaptcha
Phone
This field is for validation purposes and should be left unchanged.

Thank you for choosing Drug Crafters Pharmacy; we value your trust and look forward to addressing your questions.

Download Our Mobile App Now!
Request refills, look up prescriptions, see your medication history, set medication reminders and more.

214-618-3511

877-378-4272

214-618-3539

888-378-4271

pharmacist@drugcrafters.com

5680 Frisco Square Blvd #1100 Frisco, TX 75034