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Prescription Refill Request

Please fill out the Prescription Refill Request below.

All refill request will be handled within 48 hours.  Please list all meds, dosage and pharmacy. Please check with your pharmacy to see if meds have been refilled. 

90 day refills will not be done without current labs and visit.  

We will contact you via email if you need to make an appointment before refill request can be granted.

Thanks for submitting! Someone will contact you soon if needed!

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