I agree that the prescriptions I am submitting are only for the individual to whom
they are prescribed. Carroll Pharmacy reserves the right to validate any or all
of my prescription refills due to the lack of personal validation and has the right
to deny my prescription refill requests, until further validation is provided.
Please fill in the form below and follow the directions provided. Your refill request
will be sent securely to Carroll Pharmacy. We will fill the order and keep it at
the pharmacy counter, ready for pick up at your convenience.