Refill Request
Request Prescription

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  
Coenzyme Q10 Capsules Coenzyme Q10 CapsulesCoenzyme Q10 Capsules $100.00
$100.00
Pregnenolone Cream Pregnenolone CreamPregnenolone Cream $100.00
$100.00
Bi-est Cream Bi-est CreamBi-est Cream $100.00
$100.00
Bimatoprost Eyelash Solution Bimatoprost Eyelash SolutionBimatoprost Eyelash Solution $100.00
$100.00
Cholecalciferol (Vitamin D3) Capsules Cholecalciferol (Vitamin D3) CapsulesCholecalciferol (Vitamin D3) Capsules $100.00
$100.00
BCAA Injection BCAA InjectionBCAA Injection $100.00
$100.00
Zolpidem Tartrate Tablets Zolpidem Tartrate TabletsZolpidem Tartrate Tablets $100.00
$100.00
Vitamin E Softgel Capsules Vitamin E Softgel CapsulesVitamin E Softgel Capsules $100.00
$200.00
Melatonin Capsules Melatonin CapsulesMelatonin Capsules $100.00
$100.00
Biotin / Minoxidil / Spironolactone Capsules Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules $100.00
$100.00
Arousal Cream Arousal CreamArousal Cream $100.00
$100.00
Bi-Est Vaginal Cream Bi-Est Vaginal CreamBi-Est Vaginal Cream $100.00
$100.00
Placeholder PlaceholderSermorelin Acetate Injection $100.00
$100.00
Estradiol Patch Estradiol PatchEstradiol Patch $100.00
$100.00
Bella Capsules Bella CapsulesBella Capsules $100.00
$100.00
Propranolol Tablets Propranolol TabletsPropranolol Tablets $100.00
$100.00
GHK-Cu Facial Serum GHK-Cu Facial SerumGHK-Cu Facial Serum $100.00
$100.00

Billing details

Provider Details

Patient Details

Prescription

Your order

Product Subtotal
Coenzyme Q10 CapsulesCoenzyme Q10 Capsules  × 1 $100.00
Pregnenolone CreamPregnenolone Cream  × 1 $100.00
Bi-est CreamBi-est Cream  × 1 $100.00
Bimatoprost Eyelash SolutionBimatoprost Eyelash Solution  × 1 $100.00
Cholecalciferol (Vitamin D3) CapsulesCholecalciferol (Vitamin D3) Capsules  × 1 $100.00
BCAA InjectionBCAA Injection  × 1 $100.00
Zolpidem Tartrate TabletsZolpidem Tartrate Tablets  × 1 $100.00
Vitamin E Softgel CapsulesVitamin E Softgel Capsules  × 2 $200.00
Melatonin CapsulesMelatonin Capsules  × 1 $100.00
Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules  × 1 $100.00
Arousal CreamArousal Cream  × 1 $100.00
Bi-Est Vaginal CreamBi-Est Vaginal Cream  × 1 $100.00
PlaceholderSermorelin Acetate Injection  × 1 $100.00
Estradiol PatchEstradiol Patch  × 1 $100.00
Bella CapsulesBella Capsules  × 1 $100.00
Propranolol TabletsPropranolol Tablets  × 1 $100.00
GHK-Cu Facial SerumGHK-Cu Facial Serum  × 1 $100.00
Subtotal $1,800.00
Shipping

Shipping to TX.

Total $1,800.00

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  
Coenzyme Q10 Capsules Coenzyme Q10 CapsulesCoenzyme Q10 Capsules $100.00
$100.00
Pregnenolone Cream Pregnenolone CreamPregnenolone Cream $100.00
$100.00
Bi-est Cream Bi-est CreamBi-est Cream $100.00
$100.00
Bimatoprost Eyelash Solution Bimatoprost Eyelash SolutionBimatoprost Eyelash Solution $100.00
$100.00
Cholecalciferol (Vitamin D3) Capsules Cholecalciferol (Vitamin D3) CapsulesCholecalciferol (Vitamin D3) Capsules $100.00
$100.00
BCAA Injection BCAA InjectionBCAA Injection $100.00
$100.00
Zolpidem Tartrate Tablets Zolpidem Tartrate TabletsZolpidem Tartrate Tablets $100.00
$100.00
Vitamin E Softgel Capsules Vitamin E Softgel CapsulesVitamin E Softgel Capsules $100.00
$200.00
Melatonin Capsules Melatonin CapsulesMelatonin Capsules $100.00
$100.00
Biotin / Minoxidil / Spironolactone Capsules Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules $100.00
$100.00
Arousal Cream Arousal CreamArousal Cream $100.00
$100.00
Bi-Est Vaginal Cream Bi-Est Vaginal CreamBi-Est Vaginal Cream $100.00
$100.00
Placeholder PlaceholderSermorelin Acetate Injection $100.00
$100.00
Estradiol Patch Estradiol PatchEstradiol Patch $100.00
$100.00
Bella Capsules Bella CapsulesBella Capsules $100.00
$100.00
Propranolol Tablets Propranolol TabletsPropranolol Tablets $100.00
$100.00
GHK-Cu Facial Serum GHK-Cu Facial SerumGHK-Cu Facial Serum $100.00
$100.00

Billing details

Provider Details

Patient Details

Prescription

Your order

Product Subtotal
Coenzyme Q10 CapsulesCoenzyme Q10 Capsules  × 1 $100.00
Pregnenolone CreamPregnenolone Cream  × 1 $100.00
Bi-est CreamBi-est Cream  × 1 $100.00
Bimatoprost Eyelash SolutionBimatoprost Eyelash Solution  × 1 $100.00
Cholecalciferol (Vitamin D3) CapsulesCholecalciferol (Vitamin D3) Capsules  × 1 $100.00
BCAA InjectionBCAA Injection  × 1 $100.00
Zolpidem Tartrate TabletsZolpidem Tartrate Tablets  × 1 $100.00
Vitamin E Softgel CapsulesVitamin E Softgel Capsules  × 2 $200.00
Melatonin CapsulesMelatonin Capsules  × 1 $100.00
Biotin / Minoxidil / Spironolactone CapsulesBiotin / Minoxidil / Spironolactone Capsules  × 1 $100.00
Arousal CreamArousal Cream  × 1 $100.00
Bi-Est Vaginal CreamBi-Est Vaginal Cream  × 1 $100.00
PlaceholderSermorelin Acetate Injection  × 1 $100.00
Estradiol PatchEstradiol Patch  × 1 $100.00
Bella CapsulesBella Capsules  × 1 $100.00
Propranolol TabletsPropranolol Tablets  × 1 $100.00
GHK-Cu Facial SerumGHK-Cu Facial Serum  × 1 $100.00
Subtotal $1,800.00
Shipping

Shipping to TX.

Total $1,800.00

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.