{"id":1114,"date":"2024-08-20T17:40:42","date_gmt":"2024-08-20T17:40:42","guid":{"rendered":"https:\/\/nimble-riddle.flywheelsites.com\/?page_id=1114"},"modified":"2025-07-18T02:48:44","modified_gmt":"2025-07-18T06:48:44","slug":"rx-refill-form","status":"publish","type":"page","link":"https:\/\/progresspharmacy.com\/rx-refill-form\/","title":{"rendered":"RX Refill Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1114\" class=\"elementor elementor-1114\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6a571c0 e-flex e-con-boxed e-con e-parent\" data-id=\"6a571c0\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-e50dda7 e-con-full e-flex e-con e-child\" data-id=\"e50dda7\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ae16704 elementor-widget elementor-widget-heading\" data-id=\"ae16704\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">RX Refill Form<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ec807de e-con-full e-flex e-con e-child\" data-id=\"ec807de\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-530d0a1 e-con-full e-flex e-con e-child\" data-id=\"530d0a1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7887156 elementor-widget elementor-widget-heading\" data-id=\"7887156\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Taking care of our patients is our number one priority. We believe true healing comes through natural health and wellness<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-563d01f elementor-widget elementor-widget-image\" data-id=\"563d01f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"305\" height=\"388\" src=\"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/Mask-group.png\" class=\"attachment-full size-full wp-image-1135\" alt=\"Mask\" srcset=\"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/Mask-group.png 305w, https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/Mask-group-236x300.png 236w\" sizes=\"(max-width: 305px) 100vw, 305px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c1f8fd3 e-con-full e-flex e-con e-child\" data-id=\"c1f8fd3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b95ab12 elementor-widget elementor-widget-html\" data-id=\"b95ab12\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script type=\"text\/javascript\" src=\"https:\/\/hipaa.jotform.com\/jsform\/92866536284470\"><\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f31d291 e-con-full e-flex e-con e-child\" data-id=\"f31d291\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4e9e2e0 elementor-widget elementor-widget-html\" data-id=\"4e9e2e0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"marquee-right\">\r\n    <div class=\"marquee__group\">\r\n      <span>Priority<\/span> \r\n      <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/small-img2.png\"><\/span>\r\n      <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/Group-66.png\"><\/span>\r\n     <span>Wellness<\/span> \r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/small-img3.png\"><\/span>\r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/Group-66.png\"><\/span>\r\n     <span>Commitment<\/span> \r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/small-img1.png\"><\/span>\r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/Group-66.png\"><\/span>\r\n      \r\n    <\/div>\r\n  <div class=\"marquee__group\" aria-hidden=\"true\">\r\n      <span>Priority<\/span> \r\n      <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/small-img2.png\"><\/span>\r\n      <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/Group-66.png\"><\/span>\r\n     <span>Wellness<\/span> \r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/small-img3.png\"><\/span>\r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/Group-66.png\"><\/span>\r\n     <span>Commitment<\/span> \r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/small-img1.png\"><\/span>\r\n     <span><img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/08\/Group-66.png\"><\/span>\r\n      \r\n    <\/div>\r\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c8b4fc3 e-con-full e-flex e-con e-parent\" data-id=\"c8b4fc3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9c751ae elementor-widget elementor-widget-template\" data-id=\"9c751ae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"template.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-template\">\n\t\t\t\t\t<div data-elementor-type=\"container\" data-elementor-id=\"929\" class=\"elementor elementor-929\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t<div class=\"elementor-element elementor-element-47523aa2 e-flex e-con-boxed e-con e-parent\" data-id=\"47523aa2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-1b417e4b e-con-full e-flex e-con e-child\" data-id=\"1b417e4b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-2c5a03d0 e-con-full e-flex e-con e-child\" data-id=\"2c5a03d0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-19ccaca4 elementor-widget elementor-widget-heading\" data-id=\"19ccaca4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Connect with us<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-721cc9d elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"721cc9d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-map-marker-alt\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M172.268 501.67C26.97 291.031 0 269.413 0 192 0 85.961 85.961 0 192 0s192 85.961 192 192c0 77.413-26.97 99.031-172.268 309.67-9.535 13.774-29.93 13.773-39.464 0zM192 272c44.183 0 80-35.817 80-80s-35.817-80-80-80-80 35.817-80 80 35.817 80 80 80z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">8170 Okeechobee Blvd #5,<br \/>West Palm Beach, FL 33411<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-75879c37 e-con-full e-flex e-con e-child\" data-id=\"75879c37\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1892af3 elementor-widget elementor-widget-heading\" data-id=\"1892af3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Retail Contact Info<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8f62090 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"8f62090\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:5617202676\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-phone-alt\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M497.39 361.8l-112-48a24 24 0 0 0-28 6.9l-49.6 60.6A370.66 370.66 0 0 1 130.6 204.11l60.6-49.6a23.94 23.94 0 0 0 6.9-28l-48-112A24.16 24.16 0 0 0 122.6.61l-104 24A24 24 0 0 0 0 48c0 256.5 207.9 464 464 464a24 24 0 0 0 23.4-18.6l24-104a24.29 24.29 0 0 0-14.01-27.6z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">(561) 720-2676<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:5617202685\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-fax\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M480 160V77.25a32 32 0 0 0-9.38-22.63L425.37 9.37A32 32 0 0 0 402.75 0H160a32 32 0 0 0-32 32v448a32 32 0 0 0 32 32h320a32 32 0 0 0 32-32V192a32 32 0 0 0-32-32zM288 432a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm0-128a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm128 128a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm0-128a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm0-112H192V64h160v48a16 16 0 0 0 16 16h48zM64 128H32a32 32 0 0 0-32 32v320a32 32 0 0 0 32 32h32a32 32 0 0 0 32-32V160a32 32 0 0 0-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">(561) 720-2685<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"mailto:info@progresspharmacy.com\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-envelope\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M502.3 190.8c3.9-3.1 9.7-.2 9.7 4.7V400c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V195.6c0-5 5.7-7.8 9.7-4.7 22.4 17.4 52.1 39.5 154.1 113.6 21.1 15.4 56.7 47.8 92.2 47.6 35.7.3 72-32.8 92.3-47.6 102-74.1 131.6-96.3 154-113.7zM256 320c23.2.4 56.6-29.2 73.4-41.4 132.7-96.3 142.8-104.7 173.4-128.7 5.8-4.5 9.2-11.5 9.2-18.9v-19c0-26.5-21.5-48-48-48H48C21.5 64 0 85.5 0 112v19c0 7.4 3.4 14.3 9.2 18.9 30.6 23.9 40.7 32.4 173.4 128.7 16.8 12.2 50.2 41.8 73.4 41.4z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">info@progresspharmacy.com<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ea75b8f e-con-full e-flex e-con e-child\" data-id=\"ea75b8f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2b9c9a9 elementor-widget elementor-widget-heading\" data-id=\"2b9c9a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Mail Order<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e7f4b6f elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"e7f4b6f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:8552121997\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-phone-alt\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M497.39 361.8l-112-48a24 24 0 0 0-28 6.9l-49.6 60.6A370.66 370.66 0 0 1 130.6 204.11l60.6-49.6a23.94 23.94 0 0 0 6.9-28l-48-112A24.16 24.16 0 0 0 122.6.61l-104 24A24 24 0 0 0 0 48c0 256.5 207.9 464 464 464a24 24 0 0 0 23.4-18.6l24-104a24.29 24.29 0 0 0-14.01-27.6z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">(855) 212-1997<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:8666700314\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-fax\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M480 160V77.25a32 32 0 0 0-9.38-22.63L425.37 9.37A32 32 0 0 0 402.75 0H160a32 32 0 0 0-32 32v448a32 32 0 0 0 32 32h320a32 32 0 0 0 32-32V192a32 32 0 0 0-32-32zM288 432a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm0-128a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm128 128a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm0-128a16 16 0 0 1-16 16h-32a16 16 0 0 1-16-16v-32a16 16 0 0 1 16-16h32a16 16 0 0 1 16 16zm0-112H192V64h160v48a16 16 0 0 0 16 16h48zM64 128H32a32 32 0 0 0-32 32v320a32 32 0 0 0 32 32h32a32 32 0 0 0 32-32V160a32 32 0 0 0-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">(866) 670-0314<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"mailto:support@progresspharmacy.com\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-envelope\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M502.3 190.8c3.9-3.1 9.7-.2 9.7 4.7V400c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V195.6c0-5 5.7-7.8 9.7-4.7 22.4 17.4 52.1 39.5 154.1 113.6 21.1 15.4 56.7 47.8 92.2 47.6 35.7.3 72-32.8 92.3-47.6 102-74.1 131.6-96.3 154-113.7zM256 320c23.2.4 56.6-29.2 73.4-41.4 132.7-96.3 142.8-104.7 173.4-128.7 5.8-4.5 9.2-11.5 9.2-18.9v-19c0-26.5-21.5-48-48-48H48C21.5 64 0 85.5 0 112v19c0 7.4 3.4 14.3 9.2 18.9 30.6 23.9 40.7 32.4 173.4 128.7 16.8 12.2 50.2 41.8 73.4 41.4z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">support@progresspharmacy.com<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-20787cc8 e-con-full e-flex e-con e-child\" data-id=\"20787cc8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-59c5e1fd elementor-widget elementor-widget-google_maps\" 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