Refill Request
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Your RX number is a key part of tracking your prescription. Find it just above your name on the prescription label from Raff and Hall Pharmacy for fast access.

Refill Request
Request Prescription Form

Provider Details

Patient Details

Product Price Qty Total  
Estriol Vaginal Cream Estriol Vaginal CreamEstriol Vaginal Cream $100.00
$100.00
Allopurinol Tablets Allopurinol TabletsAllopurinol Tablets $100.00
$100.00
Quad-Mix Injection Quad-Mix InjectionQuad-Mix Injection $100.00
$100.00
DHEA Capsules DHEA CapsulesDHEA Capsules $100.00
$200.00
NAD+ Nasal Spray NAD+ Nasal SprayNAD+ Nasal Spray $100.00
$100.00
Arousal Cream Arousal CreamArousal Cream $100.00
$100.00
Placeholder PlaceholderTestosterone Cypionate Injection $100.00
$100.00
Ezetimibe Tablets Ezetimibe TabletsEzetimibe Tablets $100.00
$100.00
Bupropion HCl SR Tablets Bupropion HCl SR TabletsBupropion HCl SR Tablets $100.00
$300.00
Cyanocobalamin Tablets Cyanocobalamin TabletsCyanocobalamin Tablets $100.00
$100.00
Methylene-Blue-Capsules Methylene-Blue-CapsulesMethylene Blue Capsules $100.00
$100.00
Placeholder PlaceholderModafinil Tablets $100.00
$100.00
Acne Ultra Gel Acne Ultra GelAcne Ultra Gel $100.00
$100.00
Anti-Fungal Nail Solution Anti-Fungal Nail SolutionAnti-Fungal Nail Solution $100.00
$100.00
Melatonin Capsules Melatonin CapsulesMelatonin Capsules $100.00
$100.00
Bella Capsules Bella CapsulesBella Capsules $100.00
$100.00
Biotin / Minoxidil / Spironolactone Capsules Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules $100.00
$200.00
Placeholder PlaceholderTestosterone Vaginal Cream $100.00
$100.00
Low Dose Naltrexone (LDN) Capsules Low Dose Naltrexone (LDN) CapsulesLow Dose Naltrexone (LDN) Capsules $100.00
$100.00
Coenzyme Q10 Capsules Coenzyme Q10 CapsulesCoenzyme Q10 Capsules $100.00
$100.00
Anti-Aging Vita Gel Anti-Aging Vita GelAnti-Aging Vita Gel $100.00
$100.00
Hydroxocobalamin (Vitamin B12) Injection Hydroxocobalamin (Vitamin B12) InjectionHydroxocobalamin (Vitamin B12) Injection $100.00
$100.00
Anti-Aging Siro Gel Anti-Aging Siro GelAnti-Aging Siro Gel $100.00
$100.00

Billing details

Provider Details

Patient Details

Prescription

Your order

Product Subtotal
Estriol Vaginal CreamEstriol Vaginal Cream  × 1 $100.00
Allopurinol TabletsAllopurinol Tablets  × 1 $100.00
Quad-Mix InjectionQuad-Mix Injection  × 1 $100.00
DHEA CapsulesDHEA Capsules  × 2 $200.00
NAD+ Nasal SprayNAD+ Nasal Spray  × 1 $100.00
Arousal CreamArousal Cream  × 1 $100.00
PlaceholderTestosterone Cypionate Injection  × 1 $100.00
Ezetimibe TabletsEzetimibe Tablets  × 1 $100.00
Bupropion HCl SR TabletsBupropion HCl SR Tablets  × 3 $300.00
Cyanocobalamin TabletsCyanocobalamin Tablets  × 1 $100.00
Methylene-Blue-CapsulesMethylene Blue Capsules  × 1 $100.00
PlaceholderModafinil Tablets  × 1 $100.00
Acne Ultra GelAcne Ultra Gel  × 1 $100.00
Anti-Fungal Nail SolutionAnti-Fungal Nail Solution  × 1 $100.00
Melatonin CapsulesMelatonin Capsules  × 1 $100.00
Bella CapsulesBella Capsules  × 1 $100.00
Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules  × 2 $200.00
PlaceholderTestosterone Vaginal Cream  × 1 $100.00
Low Dose Naltrexone (LDN) CapsulesLow Dose Naltrexone (LDN) Capsules  × 1 $100.00
Coenzyme Q10 CapsulesCoenzyme Q10 Capsules  × 1 $100.00
Anti-Aging Vita GelAnti-Aging Vita Gel  × 1 $100.00
Hydroxocobalamin (Vitamin B12) InjectionHydroxocobalamin (Vitamin B12) Injection  × 1 $100.00
Anti-Aging Siro GelAnti-Aging Siro Gel  × 1 $100.00
Subtotal $2,700.00
Shipping

Shipping to TX.

Total $2,700.00

Payment method

Your personal data will be used to process your order, support your experience throughout this website, and for other purposes described in our privacy policy.

 *
Request Prescription Form

Provider Details

Patient Details

Request Prescription Form
Product Price Qty Total  
Estriol Vaginal Cream Estriol Vaginal CreamEstriol Vaginal Cream $100.00
$100.00
Allopurinol Tablets Allopurinol TabletsAllopurinol Tablets $100.00
$100.00
Quad-Mix Injection Quad-Mix InjectionQuad-Mix Injection $100.00
$100.00
DHEA Capsules DHEA CapsulesDHEA Capsules $100.00
$200.00
NAD+ Nasal Spray NAD+ Nasal SprayNAD+ Nasal Spray $100.00
$100.00
Arousal Cream Arousal CreamArousal Cream $100.00
$100.00
Placeholder PlaceholderTestosterone Cypionate Injection $100.00
$100.00
Ezetimibe Tablets Ezetimibe TabletsEzetimibe Tablets $100.00
$100.00
Bupropion HCl SR Tablets Bupropion HCl SR TabletsBupropion HCl SR Tablets $100.00
$300.00
Cyanocobalamin Tablets Cyanocobalamin TabletsCyanocobalamin Tablets $100.00
$100.00
Methylene-Blue-Capsules Methylene-Blue-CapsulesMethylene Blue Capsules $100.00
$100.00
Placeholder PlaceholderModafinil Tablets $100.00
$100.00
Acne Ultra Gel Acne Ultra GelAcne Ultra Gel $100.00
$100.00
Anti-Fungal Nail Solution Anti-Fungal Nail SolutionAnti-Fungal Nail Solution $100.00
$100.00
Melatonin Capsules Melatonin CapsulesMelatonin Capsules $100.00
$100.00
Bella Capsules Bella CapsulesBella Capsules $100.00
$100.00
Biotin / Minoxidil / Spironolactone Capsules Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules $100.00
$200.00
Placeholder PlaceholderTestosterone Vaginal Cream $100.00
$100.00
Low Dose Naltrexone (LDN) Capsules Low Dose Naltrexone (LDN) CapsulesLow Dose Naltrexone (LDN) Capsules $100.00
$100.00
Coenzyme Q10 Capsules Coenzyme Q10 CapsulesCoenzyme Q10 Capsules $100.00
$100.00
Anti-Aging Vita Gel Anti-Aging Vita GelAnti-Aging Vita Gel $100.00
$100.00
Hydroxocobalamin (Vitamin B12) Injection Hydroxocobalamin (Vitamin B12) InjectionHydroxocobalamin (Vitamin B12) Injection $100.00
$100.00
Anti-Aging Siro Gel Anti-Aging Siro GelAnti-Aging Siro Gel $100.00
$100.00

Billing details

Provider Details

Patient Details

Prescription

Your order

Product Subtotal
Estriol Vaginal CreamEstriol Vaginal Cream  × 1 $100.00
Allopurinol TabletsAllopurinol Tablets  × 1 $100.00
Quad-Mix InjectionQuad-Mix Injection  × 1 $100.00
DHEA CapsulesDHEA Capsules  × 2 $200.00
NAD+ Nasal SprayNAD+ Nasal Spray  × 1 $100.00
Arousal CreamArousal Cream  × 1 $100.00
PlaceholderTestosterone Cypionate Injection  × 1 $100.00
Ezetimibe TabletsEzetimibe Tablets  × 1 $100.00
Bupropion HCl SR TabletsBupropion HCl SR Tablets  × 3 $300.00
Cyanocobalamin TabletsCyanocobalamin Tablets  × 1 $100.00
Methylene-Blue-CapsulesMethylene Blue Capsules  × 1 $100.00
PlaceholderModafinil Tablets  × 1 $100.00
Acne Ultra GelAcne Ultra Gel  × 1 $100.00
Anti-Fungal Nail SolutionAnti-Fungal Nail Solution  × 1 $100.00
Melatonin CapsulesMelatonin Capsules  × 1 $100.00
Bella CapsulesBella Capsules  × 1 $100.00
Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules  × 2 $200.00
PlaceholderTestosterone Vaginal Cream  × 1 $100.00
Low Dose Naltrexone (LDN) CapsulesLow Dose Naltrexone (LDN) Capsules  × 1 $100.00
Coenzyme Q10 CapsulesCoenzyme Q10 Capsules  × 1 $100.00
Anti-Aging Vita GelAnti-Aging Vita Gel  × 1 $100.00
Hydroxocobalamin (Vitamin B12) InjectionHydroxocobalamin (Vitamin B12) Injection  × 1 $100.00
Anti-Aging Siro GelAnti-Aging Siro Gel  × 1 $100.00
Subtotal $2,700.00
Shipping

Shipping to TX.

Total $2,700.00

Payment method

Your personal data will be used to process your order, support your experience throughout this website, and for other purposes described in our privacy policy.

 *
Frequently asked questions
Our dedicated team of specialists is ready to help you find the answers you’re looking for.
Can Raff and Hall Reach Out to My Doctor Directly for Prescription Refills?

Yes, we can handle contacting your doctor for your refill request. Please note that response times from their office may vary depending on their availability.

Yes, you can conveniently request a refill by heading to our Refill Request page and completing the form.

We do not offer automatic refills. Since many of our medications are prescribed on an “as needed” basis, we aim to avoid billing patients for medications they may no longer require. Additionally, automatic refills could lead to issues with package delivery if the recipient is not available to accept it.

The time required to fill or compound a prescription can vary for each case. On average, most orders are shipped within 7 business days, provided we receive your prescription by 7:00 PM CST. Kindly note that after receiving a prescription from your physician, we will reach out for your approval prior to filling it, unless directed otherwise.

When requesting a refill, make sure to clarify how you’d like to receive your medication. If you prefer home delivery, fill in your shipping details and choose a shipping method. Alternatively, if you plan to pick it up at our facility, please select the “Patient Pickup” option on the form.