REFILL REQUEST FORM

If you have received travel-related prescription medications from us in the past (including items in our travel medicine kits), you can request a refill. Prescriptions can be filled through our in-house pharmacy, or in some cases, through your local pharmacy. Refills done through our pharmacy are $45, and refills done through a local pharmacy are $75.

Print and Fax Option

You can download and print our Adobe PDF version here. After you complete the form, fax it to the number printed on the form.