Request Prescription Refill Here
   
Close Window
 
   


Please Read this Important Notice:

To be eligible foe the service,
you must be a patient whom we have seen within the past 12 months.


We understand that due to scheduling, occasionally your prescription may expire before your next appointment. We will provide a one time extension of your prescription for enough medication until your next visit. In order to give you a sufficient amount of refills, you must have an appointment confirmed prior to your request.

We will not prescribe medications which we have not previously prescribed for you. All requests must be approved by your physician, and may be denied if we feel that it is medically necessary that we evaluate your condition prior to continuing a medication.

If your request is denied, you will be contacted by phone, along with any additional instructions. Please allow 2-3 days for your medication to be called to your pharmacy.

We will check incoming prescription requests via email 
at 11:00 AM and 3:00 PM Monday thru Thursday. 
Requests made after 11:00 AM on Fridays and on weekends 
will be picked up on the following Monday.

If you have an urgent need that needs to be addressed sooner, please
contact us by phone at 919-781-5510


Request a Refill for Your Prescription by filling out form below

Full Name
Date of Birth
Daytime Phone #

Email Address

Pharmacy Name
Pharmacy Phone #
Medication Name
Dosage
Comments


 
     
     
     
     
     
   
 
   
Close Window