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604-533-1041

105 –19475 Fraser Hwy Surrey, BC. V3S 6K7

Vaccination Form

Prescription Refills

Surlang Pharmacy.Logo

Surlang Pharmacy

Medicine Centre Pharmacy Surrey

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Prescription Refill

Order your prescription refill now using our Rx Refill Form.

Home / Pharmacy Services / Prescriptions / Prescription Refill

Prescription Refill Form

Complete the form below. It will be sent to our pharmacy staff who will use the information provided to confirm, and refill your prescription for you.

  • MM slash DD slash YYYY
  • Note: If you do not receive an automated e-mail message within 24-hours to confirm your on-line prescription refill(s) request, please phone 604-533-1041 for personal assistance.
  • Your Prescriptions

    You may include up to six prescriptions.
  • Instructions

    • You may include up to six prescriptions.
    • You must include a Medication Description OR Prescription Number.
    • If you use a prescription number, please make sure it's the most recent prescription number.
  • 1. Medication Description OR Prescription number
  • 2. Medication Description OR Prescription number
  • 3. Medication Description OR Prescription number
  • 4. Medication Description OR Prescription number
  • 5. Medication Description OR Prescription number
  • 6. Medication Description OR Prescription number
  • Pick Up & Delivery

  • Please let us know when you would like to pick up this prescription at our location. (This is required).
    MM slash DD slash YYYY
  • Use this field to include any extra details you feel we may need to know when filling your prescription.

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Surlang Medicine Centre Pharmacy

Surlang Pharmacy is a full-service retail and compounding pharmacy providing prescription medications, BHRT hormone therapy, veterinary compounding, and health consultations.

Contact Information

Address:
105 –19475 Fraser Hwy
Surrey, British Columbia, V3S 6K7

Tel: 604-533-1041

Fax: 604-533-1051

Email: surlangpharmacy12@gmail.com

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Surlang Pharmacy Business Hours

  • Monday9:30 AM - 5:30 PM
  • Tuesday9:30 AM - 5:30 PM
  • Wednesday9:30 AM - 5:30 PM
  • Thursday9:30 AM - 5:30 PM
  • Friday9:30 AM - 5:30 PM
  • Saturday9:30 AM - 4:00 PM
  • Sunday & HolidaysClosed
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