Pharmacy Refill Requests - Community Pharmacy

Thank you for choosing the St. Alexius Community Pharmacy.
If you have any questions with this online process or your medications, feel free to call us at 701.530.6906.

Community Pharmacy, 900 East Broadway, Bismarck
(located at the East Patient Entrance on the corner of Rosser and 10th Street or Community Pharmacy Curbside Pickup Service)

-Back to Community Pharmacy-

Information Change

Yes

Has your personal information changed since your last prescription refill?

Generic Drugs

Yes

Are generic drugs acceptable?

Delivery Method

At the Pharmacy

Mail the prescription

First Name *

Last Name *

Address *

Address 2

City *

State *

Zip Code *

Phone Number *

(xxx)xxx-xxxx format

Email Address *

Refill Number

Medication Name

Refill number medication name

Refill #2 Number

Refill #2 Medication Name

Refill #2 number medication name

Refill #3 Number

Refill #3 Medication Name

Refill #3 number medication name

Refill #4 Number

Refill #4 Medication Name

Refill #4 number medication name

Search form

Search form

Pharmacy Refill Requests - Community Pharmacy

General Information