Request Your Medication Refill

Quick, secure, and seamless. Submit your request online, pay the $35 processing fee, and we’ll take care of the rest.

HIPAA-compliant form Secure Stripe checkout Mobile-friendly Reviewed in 1–2 business days

💊 Request a Refill Opens a secure Revivify portal in a new tab

Tell us your medication(s) and any updates to your health.

Payment is processed via encrypted Stripe checkout. You’ll get a receipt instantly. (RX payments processed separetely.

We review your request within 1–2 business days. Most deliveries arrive in 7–10 business days.

How long will it take?

We review requests in 1–2 business days. After approval, pharmacy shipping is typically 7–10 business days.

Will I get a receipt?

Yes—Stripe emails you an instant payment receipt. You’ll also receive a confirmation email from Revivify Wellness.

What if I need a dose change or want to discuss my plan?

You can schedule a quick follow-up visit. If your provider needs to chat before approving a refill, we’ll reach out.

Can I request multiple medications?

Yes—list all medications and doses in the form. We’ll review everything together.

Submitting a request does not guarantee a refill. Medical appropriateness and any follow-up requirements are determined by your provider.