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Request Prescription Refill

After sending this form, your prescription request will be processed and our team will have your prescription refill ready for pickup in 48 hours.

Refill pickups are available from Monday-Thursday between 04:00PM - 05:00PM and Friday between 11:00AM - 12:00PM.
Prescription Refill

Refill Request Form

General Information


Medical Information


Confirm & Request


Any questions?

Don't hesitate to write us an email or give us a call during our opening hours at our Medical or Rehab Center.
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Medical Clinic

Konrad-Adenauer-Straße 4, 66849 Landstuhl
06371 49 50 21

Monday - Thursday: 
08:00 AM – 12:00 PM and 
01:00 PM – 05:30 PM 
Friday: 08:00 AM – 12:30 PM
Saturday & Sunday: closed
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