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If you are already an established patient with our practice and need prescription refills or referrals, you may use the following request forms:Prescription refill request form Click here to request prescription refills. Print out the form, complete it, and forward it to our office (fax, mail, or personal delivery) when a prescription refill is needed. If it is more convenient for you, take the form to your pharmacy to fax it to us. Please complete one form for each prescription refill needed. Please note that an office appointment may be needed if you are requesting a new prescription, a medication change, a refill of a controlled medication, or if it has been a more than a few months since you were last examined. Referral request form Click here to access the referral request form. Print out the form, complete it, and forward it to our office (fax, mail, or personal delivery) when a referral authorization is needed for specialist consultation, testing, or a surgical or other therapeutic procedure. |