ATTENTION ALL CUSTOMERS:
Due to a recent change in our pharmacy software system, the process for submitting refill requests online has now changed.
Our previous mobile app and your current login credentials will no longer work.
Please click the Patient Portal tab to begin the new process.
Thank you for your patience during this transition.

New Prescriptions

We would love the opportunity to serve as your trusted prescription provider.
Please fill out the form below and we will take it from here!

You must bring original prescription with you when you come to pickup.

First Name

Last Name

Email Address

Phone Number

Birth Date (XX/XX/XXXX)

Provider Name

Provider Phone Number

Medication Name

Strength / Quantity

Medication Name

Strength / Quantity

Medication Name

Strength / Quantity

Medication Name

Strength / Quantity

Message to Pharmacist

Our commitment to patient care and health is priority one here at Heike Pharmacy.

We believe in the value of providing personalized service and quality products.

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Contact Us

Heike Pharmacy
213 W Main St, Durand, WI 54736
(715) 672-5202 - (715) 672-5205