Do you have questions about your prescription? Please complete the form below to submit your request.
This form is for NON-URGENT prescription requests only. Your request will be returned as soon as possible (within 24 hours or the next business day). You will be contacted by PHONE to confirm your request.
If you are having an emergency, please call our office to speak to the doctor on call, or go to the nearest emergency room.
Disclaimer: In an effort to continue to protect your privacy and remain HIPAA compliant, we respectfully request that you do not enter any personal identifying information, such as your birth date or medical information.