Prescription Refill

Request a medication refill with current prescription, pharmacy, remaining supply, provider approval, pickup preference, and status context. This example brings Medication and Pharmacy together so patients and care teams can find the next task without losing context.

It includes representative records such as Confirm medication and Choose pharmacy. Use the screenshot to study the layout, then adapt its components and product states to your own design system.

Prescription Refill
Use this template in Figr

Template facts

Screen

Form

Primary action

Request refill

Pattern

Form

State

Default, loading, empty, error, permission, success

Design system

Configurable product UI theme

What this screen helps users do

Care team members need to request refill while keeping refills available, days remaining and exceptions visible. The interface should show what changed and who should act next.

Key elements

  • Main workspace: Medication gives users an obvious place to start.
  • Supporting view: Pharmacy keeps the related context close.
  • Primary action: Request refill stays visible when people need it.
  • First signal: Refills available shows a useful value (2).
  • Second signal: Days remaining gives additional context (6).
  • Sample record: Confirm medication.
  • Next record: Choose pharmacy.

States worth designing

  • Required field missing: say what changed, protect progress, and offer a clear next step.
  • Invalid value or incompatible data: say what changed, protect progress, and offer a clear next step.
  • Draft saved: say what changed, protect progress, and offer a clear next step.
  • Submitted for review: say what changed, protect progress, and offer a clear next step.
  • No permission to submit: say what changed, protect progress, and offer a clear next step.
  • Temporary save failure: say what changed, protect progress, and offer a clear next step.

Where this screen sits in the flow

Medication → Pharmacy → Request refill → Review outcome

Patterns used

Form, Medication, Pharmacy, contextual actions, error recovery

Why these choices work

Show requirements beside fields and retain values after failed checks. Validate only the affected input and make the next step unmistakable.

Pay attention to medication and pharmacy. People need to distinguish Confirm medication from Choose pharmacy. Keep refills available visible, especially when a record changes owner or status.

Before this screen reaches handoff, verify keyboard focus, empty and permission states, and what happens after someone chooses “Request refill”. Make error recovery as clear as the happy path.

Related screen examples to explore next: Appointment Booking, Lab Results, Patient Portal Home.

Start from this in Figr

Design a prescription refill screen inside our existing product. Use our current components, tokens and content language. Include Medication and Pharmacy views, credible records like Confirm medication, and a clear “Request refill” action. Use our product permissions and show loading, empty, error and success states. Keep the output editable in Figma.

Open Figr