Submit A Refill RequestFill out the form below if you require a prescription refill from an ND at The Health Creation Lab Name * First Name Last Name Email * Phone * (###) ### #### Supplement Full Product Name, Brand, Size Homeopathic Remedy Name, Potency, Full Tube/ Envelope/ Liquid Herbs Full herb name, Loose herb or tincture, Amount needed Anything Else That Will Help Us Get This Ready Can We Charge Your Card On File? * Yes No, I will pay in a different way. Thank you for submitting your refill request. We will contact you when your bundle is ready for pick-up/shipping.
