To request a prescription refill, please complete the Prescription Refill Request Form below, and send it back to the Pharmacist, at Inland Compounding Pharmacy. If you have any questions please call or e-mail the pharmacist for specific instructions.

Refill Request Prescriptions Form

• Home
• Prescriber
  • Introduction
  • Why Compound?
  • Triad Relationship
  • Compounding Dosage Forms
  • Request for In-Service with a Pharmicist
  • Specialties
    • Andropause - for Men
    • Menopause - for Women
    • Dental
    • Dermatology & Wound Care
    • General Practitioner
    • Pain & Sports Medicine
    • Hospice & Palliative Care
    • Pediatrics
    • Podiatry
    • Radiology/Oncology
    • Veterinary Medicine
  • Tools
    • How to Write a Compound Prescription
    • Books & References
• Patient
  • Introduction
  • Triad Relationship
  • Seminars
  • Tools
    • Patient Refill Request Form
    • Request for Patient Consultation or Concierge Consultation Service
    • Friends & Family Referral Discount Program
• Events
  • Seminar(s)
  • Community Events
  • eNewsletter
• Supplements
• About ICP
  • About ICP
  • Contact Us
  • Privacy Policy
  • Mission Statement
  • Important Links
  • Associations & Credentials
• Contact Us
• FAQs