By using this form, I agree that the prescriptions I am submitting are only for the individual to whom they are prescribed.

Purdy Cost Less Pharmacy reserves the right to validate any of my prescription refills if enough information is not submitted up front, and may deny my prescription refill request until further proof is provided.

Please fill in the form and follow the directions provided. Your refill request will be sent securely to Purdy Cost Less Pharmacy. We will process and keep the order at the pharmacy counter, ready for pick up.