Please choose one of three options to place a refill:

  1. Please have your physician complete the online form below

  2. Please upload the patient's Rx to the form at the bottom of the page or to the New Order Page via the Home Screen

  3. Please download this Refill Request PDF and either upload, email or fax into Western Allergy

Production commences upon approval.  Delivery is estimated  2-4  weeks after the prescription placement date. Status inquiries can be requested via www.westernallergy.com

Please note, patients are recommended to see their prescribing physician every 6 months for treatment reference.

Please either complete the below form, or download, fill, and either fax, email or upload the refill request pdf.

Refill Request

Western Allergy

Allergy Immunotherapy Refill Request
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Billing Address

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Shipping Address

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Thank you for your order. Please expect order confirmation within 24 hours.

 

Rx Upload

Upload File

Thank you for your order. Please expect order confirmation within 24 hours.