Medication Refill Request

Complete the form below to request a refill in your medication. Please allow up to 48 business hours for your refill to be sent to your pharmacy.

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Thank you for submitting your medication refill request. Please allow up to 48 business hours for your request to be reviewed and processed. Refill requests submitted on weekends, holidays, or outside of normal business hours will be processed during regular office hours. We are unable to guarantee same-day processing of refill requests. Please note that submitting a refill request does not guarantee that a refill will be approved. Clients who are overdue for a follow-up appointment may be required to schedule an appointment before additional refills can be authorized. If you have not heard from your pharmacy after 48 business hours, please contact your pharmacy first to verify whether a prescription has been received before submitting another refill request or contacting our office. To avoid interruptions in your medication, we encourage you to submit refill requests at least 5 business days before your medication is needed. If you are experiencing a medical or psychiatric emergency, please call 911, go to your nearest emergency room, or contact 988 for immediate support. Thank you!

In submitting the information above, I am aware that I may be sending private and confidential information through a means that does not meet the requirements of the HIPAA Privacy and Security Rules. I also understand this and any communication prior to an initial session does not constitute a patient-provider relationship. If you selected texting, by submitting your information, you consent to receive SMS communications from us. Reply STOP to any message received to unsubscribe or HELP for assistance.