Prescription Refill Request Form
Prescriptions should be ready for
pickup 3 hours after requesting. Should you need them sooner,
please let us know. Some prescription refill requests may require
authorization from your physician before filling (i.e. out of
refills). In that situation, please allow 24 hours (or until
Monday afternoon if it’s the weekend) for us to contact your
physician and to receive a reply.
*Teton Pharmacy offers free delivery to destinations within the city limits of Idaho Falls and Ammon. We can deliver your prescriptions to you at work or at home. Due to safety and privacy concerns we cannot leave items unattended and deliveries will need to be signed for. Deliveries are made throughout the day. Delivery requests made after 4 pm will be delivered the next business day. If there are any special needs, please make them in the “Notes” area below or give us a call at 208-529-3636.
To request a refill via email, please send the following information to: pharmacy@tetonpharmacy.com
- RX
numbers*
- Patient’s First Name*
- Patient’s
Last Name*
- Your
Contact information
- Your
name if different from above:
- Phone Number*
- Pickup
or Delivery*
Required fields *