At Premier, customer service is our primary focus. Just as with our customized topical formulations, we understand each patient is unique. Please submit the form below and ourĀ Pharmacist will contact you right away.

Online Prescription Refill Request

  • Enter your Rx Number(s) in the box(es) below.
    Rx NumberRx NumberRx NumberRx NumberRx NumberRx Number 
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  • (If payment method is not on file with Premier Pharmacy, please call the pharmacy at 1-844-245-2233.)
  • Special Instructions
  • Additional Supplements
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