Automatic Refill Authorization - Kelley-Ross Pharmacy 2026

1. Click ‘Get Form’ to open the Automatic Refill Authorization in the editor.
2. Begin by entering your full name in the designated field, ensuring it matches your identification for accurate processing.
3. List the medications you wish to have refilled automatically in the provided spaces. Be specific to avoid any confusion.
4. Review the Auto Refill Return Policy section carefully. Acknowledge your understanding by checking any required boxes if applicable.
5. Sign and date the form at the bottom. Make sure your signature is clear and legible for verification purposes.
6. Once completed, save your changes and submit the form directly through our platform for a seamless experience.

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