Please enter your prescription and pharmacy below and submit. We will be reaching out to you in the next 24 hours
This form is for existing patients looking to request a refill of their medication. If you are interested in becoming a new patient, please follow this link to get started!
We do not provide auto-refills through our website. Please call us at 516-505-7200 or email email@example.com to schedule an appointment.
Once scheduled, we will send an emergency refill up to 7 days to carry you until your next appointment.