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Prescription Refill Requests 

If you are a current patient in need of a prescription refill, we're here to help. Please note the following: 

• Routine refills may take up to 48 hours to process. 
• Requests made after hours or on weekends will be reviewed on the next business day. 
• For urgent refill needs, please call our office directly during business hours. 
• We recommend contacting your pharmacy first to check if any refills remain on file. 

To request a refill, you may: 

• Call our office at [Your Phone Number] 
• Send a message through your patient portal 
• Or complete the form below, and a member of our team will follow up shortly 

Please include the following in your request: 

• Full Name & Date of Birth 
• Medication Name and Dosage 
• Pharmacy Name and Phone Number 

For safety reasons, we may require an appointment or a follow-up if it has been a while since your last visit.