New Prescription

Please fill out the below form to submit a new prescription online. Take an image of your new prescription (using a camera, phone, or scanner, etc.), and upload it to the form on the right. Please ensure that the image is legible. You must present the original prescription to the pharmacy or delivery driver in order to receive your new medication.

Pick-Up     Free Delivery
Terms and Conditions
By filling out a new prescription submission form, you consent to allowing a pharmacist access to your personal health information. Furthermore, you agree to allow the pharmacist to disclose all prescription and personal health information to physician(s) and drug plans in order to maintain the standard of care when necessary.

ID may be requested upon pickup if a third party is picking up a refill on behalf of the patient.The pharmacy will give you a call once your prescription is ready .

In the case of a technical failure, Bolton Health Pharmacy cannot be held liable for delayed or lost requests.