Online Prescription Refill Fast online prescription refills "*" indicates required fields Step 1 of 6 16% This service is for a doctor to write a prescription so you can refill existing medications. It does not include copays or pharmacy fees. Pricing 1 med = $10 2 meds = $15 3 meds = $18 4 meds = $20 Medications*You may add up to four medications. Add another medication by clicking on the plus sign on the right.Medication NameDose / Frequency Add Remove First Name* Last Name* Date of Birth* Cell Phone*You will receive a text from a doctor. Street Address* Address Line 2 City* State*GAINKSMAMEMONENYNJOHSCTNZip* Your Email* You're done! Please accept the privacy agreement by checking the box below and then submit your form. A doctor will text you soon.