Medication Refill Request Form

Please allow 14-21 business days for the medication to arrive! Don't wait! Order early! Please note that should you choose to have the medication shipped to your home, Viva Beauty and Wellness is not responsible for lost, stolen, or damaged items or errors by the delivery service. Also, note that, during warmer months, the medications left outside after delivery can become unusable.

Also, a new request is required for every refill. Do not use an old payment link to submit payment as your refill