Your medical prescriptions are very important to your good health. Try to foresee the need for refills and pay close attention to the available quantity. All refill requests should be made at least one week in advance. Refill requests may be held for 48 hours, or over the weekend if the request is made on Friday, until your healthcare provider is in the office. This allows your healthcare provider to determine if the refill is appropriate. New antibiotic requests are not filled by telephone, so for this you will need to schedule an appointment.

We will e-mail you to confirm receipt of this request, then one of our triage personnel will contact you by telephone to let you know the request has been called in to your pharmacy. Please realize that this request will need to be approved by your health care provider, therefore your chart will need to be pulled and sent to him/her. We will attempt to expedite the order as quickly as possible within the business day

 

Name of Pharmacy
Location of Pharmacy
Day Phone
Name
E-mail
Date of Birth
Allergies
Your Health Care Provider
Name of Medication
Quantity Requested

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