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Prescription Refill
We now offer prescription refills on-line for your convenience. Please complete the form below in its entirety. All prescription refills require at least one week to fill. Because of the high number of prescription requests, it requires significant time to process them all. If you have an emergency request, you must call the office. As a matter of policy, Doctors will not phone in prescriptions except in "emergency" situations. Obstetrical patients requesting vitamins or iron, please request them at your next office visit. We are unable to phone in medicines for obstetrical patients. Ob patients may download the acceptable to take over the counter medication list for common problems on the Patient Information Page.



Rules for phone in prescriptions:
  1. No "new" prescriptions will be accepted.
  2. Patients who have not been seen in the office in the last 12 months may not receive prescriptions of any kind, no exceptions.
  3. Absolutely no narcotic refill prescriptions will be accepted. Narcotics will be prescribed only during an office visit.
  4. Only one internet request for a prescription refill will be accepted within one year. An office visit is required for all other refill requests.
Name: *
Today's Date:
Date of Birth: *
Email: *
Address:*
City:*
State:*
Zip Code:*
Daytime Phone: *
Medication Name: *
Rx #: *
Pharmacy Name: *
Pharmacy Phone Number:*
   
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