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Refill Request
All refill requests require 5 days to process - please plan ahead so you don't run out of your medication. All refills on controlled substances require an appointment within the past 30 days, unless otherwise notified by provider.
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Name
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First
Last
Email Address
*
Name of Medication
*
Dose
*
Name of Pharmacy
*
Pharmacy Location
*
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About
Treatment Cost
Telehealth
Patients
Portal login
Practice Documents
Medication Information
Resources
Hotlines
Referrals
>
Mental Health Referrals
Primary Care Referrals
Military & Veterans
>
Crisis Resources
Government Resources
Non-Government Resources
Therapists
Local Resources
Apps
Contact