Thank you for requesting your refill(s) via our convenient and secure online form. Please fill out all the fields below. Once you submit, please be on the lookout for a call and/or text from a friendly Mandell's Patient Care Coordinator who will help you finalize your delivery.  Your refill cannot ship until you finalize your delivery.

NOTE: IF YOU HAVE ALREADY SUBMITTED A REFILL REQUEST FOR YOUR CURRENT ORDER - PLEASE DO NOT SUBMIT MULTIPLE REQUESTS FOR YOUR REFILL ON THIS PAGE – IT WILL NOT EXPEDITE YOUR ORDER AND MAY RESULT IN DELAYS.  Please note that due to COVID-19 Coronavirus, the wait time for your scheduling and payment may be longer than usual.  However, please rest assured that we will make sure to contact you to get your refill processed by your requested need-by date.  TO FOLLOW UP ON THE STATUS OF YOUR REFILL REQUEST, PLEASE CALL US AT 877-252-0553, OPTION 8.  THANK YOU.

I also need the following: *
Next steps 
A Patient Care Coordinator will process your order as soon as possible but we will need to speak to you in order to schedule your shipment. Please watch for a text message from Mandell's, which will include directions on how to finalize your order. *
Please click submit to finalize your request.