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Refill Prescription

Upon submission of this form, Boardwalk Pharmacy will contact you with your pickup or delivery time ASAP. Desired pickup/delivery time cannot be guaranteed.

Your request has been received and you should be receiving an email confirmation in the next little bit.
We will contact you by phone if necessary.

We Deliver over-the-counter (OTC) products with your prescription refill order for free!

Step 1 - Check out our full line of products available for delivery with your prescription refill.
Step 2 - Add any products you'd like to your cart.
Step 3 - Select "Free Shipping (Delivered with Prescription)"
Step 4 - Checkout with the same name as your prescription refill.
Step 5 - We will automatically match your prescription refill with your OTC order and deliver both to you together in one package.

See Our Full Product Line

There was an error filling your prescription!

Please select your desired pickup/delivery date!

Full Name

Phone

RX Number

Don't have an RX #?

Fill out the RX # field with "0000000" & include the drug name in "Additional Instructions" below.

Pickup or Delivery?

Pickup

Delivery

Desired pickup/delivery date

Desired delivery times

Afternoon (12pm - 3pm)
Evening (4pm-8pm)

Delivery Schedule Details

Patients must fill out a refill form by 12pm LATEST to get same-day delivery in the evening (4 - 8 pm).
Anyone who fills out a form after 12 pm will be eligible for next day delivery.
There is a 6 pm cut off for next day early delivery (12 to 4 pm).

Additional Instructions

Thank You

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