Rx Refill Request
Submit your refill request below and our team will take it from there. We'll reach out via text or phone to confirm your order and arrange free delivery anywhere in Colorado and Wyoming.
HIPAA Notice
By submitting this form, you acknowledge that you are providing Protected Health Information (PHI) so that Summit Pharmacy can process your prescription refill request. The information you submit is transmitted directly to a HIPAA-compliant pharmacy email account and is accessed only by authorized pharmacy personnel. If you prefer not to send PHI electronically, please call the pharmacy at (720) 370-1121 to request your refill.
Patient Information
Fields marked with * are required
Other Ways to Request a Refill
NimbleRx App
Request refills directly through the NimbleRx patient app
Call or Fax
Phone: (720) 370-1121
Fax: (720) 370-1216
Mon – Fri, 9 AM – 6 PM
Text Us
Reply to any text from us or use the direct phone number found on your Rx label
