• FlexRx Refill Request Form

    Please complete the form below to request a FlexRx refill for your patient. Daavlin will provide the new code to the contact listed below. Refill requests are typically fulfilled within a few hours, but no later than one business day.
  •  - -
    Pick a Date
  • Clear
  • FRM-00109 [1]
  • Should be Empty: