Effective September 7th, 2018
We are no longer taking refill request from this site.
Please call the office and leave a message on the
PRESCRIPTION REFILL LINE.
We are sorry for any inconvenience!
We DO NOT accept refill request from any pharmacy!
I understand that you DO NOT take refill request through this site and I WILL NOT receive my prescriptions unless I contact the office and leave a message on the refill line. I also understand you do not take refill request from the pharmacy.
Today's Date: *(We print request and delete them daily. Back dating your request may cause a delay in you picking up your medication or getting it called to your pharmacy within 3 business days.)
Contact Phone Number
Person requesting refill
Patient First Name:
Patient Date of Birth
I currently receive medications from:
Kim Spahn, N.P.
Julie Vittori, N.P.
Stephanie Carson, N.P.
Have you been seen by one of our script writers in the last six months?
I have an appointment scheduled (if you cancel, No Show or reschedule you will not receive a refill until seen)
If it has been 3 days or more please ask that your pharmacy look to see if your medication has been put on "HOLD". This has been a big issue with pharmacies over the last 6 months.
We are now able to send
directly to the pharmacy.
Please list the pharmacy you would like your prescription sent to.
In order to receive your refill you will need to contact the office and leave a message on the refill request line. We no longer check this site for refills.