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Refill Rx (opens in a new tab)

Patient forms & requests

Handle it here instead of on the phone. For refills and secure messaging, use the patient portal (opens in a new tab).

Transfer a prescription

Tell us what to move and we'll call your current pharmacy and handle the rest.

Not for emergencies

If this is a medical emergency, call 911 or go to the nearest emergency room. For poisoning, call Poison Control at 1-800-222-1222. This form is not monitored around the clock and is not a substitute for speaking with a pharmacist — call 316-683-5621 for anything urgent.

Protected health information (PHI)

Messages sent through this form are transmitted by standard email and are not encrypted. Please share only the minimum information needed to reach you, and avoid sending diagnoses, lab results or other sensitive health details. Hart Pharmacy handles any information you do send in accordance with HIPAA and our Privacy Policy. By submitting, you consent to being contacted at the phone number or email you provide.

Medical disclaimer: Content on this site is for general information only and is not medical advice, diagnosis or treatment. Always consult your pharmacist or prescriber before starting, stopping or changing a medication.

* All fields required.

Hart Pharmacy Compounding Lab

HRT consultations

A 45-minute phone call with a compounding pharmacist to talk through your goals. Pick a time that works and we'll call you. A short questionnaire comes with your confirmation — please complete it at least an hour before the call.

Schedule HRT consultation (opens in a new tab)Call us: 316-683-5621

After the consult we send a recommendation to your provider, then compound and call you once it's ready — typically 3 days to 2 weeks. Need to reschedule? Use the link above or give us a call.

Immunization request & consent

Fill out the vaccine consent form below — you can print it and bring it with you, or email the completed copy to the pharmacy ahead of your visit.

Open fillable consent form (opens in a new tab)Download / printSend completed form to pharmacy

Prefer paper? Print the form, complete it, and bring it to the counter — no appointment required for most vaccines.

Not for emergencies

If this is a medical emergency, call 911 or go to the nearest emergency room. For poisoning, call Poison Control at 1-800-222-1222. This form is not monitored around the clock and is not a substitute for speaking with a pharmacist — call 316-683-5621 for anything urgent.

Protected health information (PHI)

Messages sent through this form are transmitted by standard email and are not encrypted. Please share only the minimum information needed to reach you, and avoid sending diagnoses, lab results or other sensitive health details. Hart Pharmacy handles any information you do send in accordance with HIPAA and our Privacy Policy. By submitting, you consent to being contacted at the phone number or email you provide.

Medical disclaimer: Content on this site is for general information only and is not medical advice, diagnosis or treatment. Always consult your pharmacist or prescriber before starting, stopping or changing a medication.

* Required. Don't include detailed health history here — we'll collect it at your appointment.