Prescription Refill

    Before filling the refill request form:
    • Make sure there are no refills left on the prescription you are requesting.
    • Once your request is sent, the reception staff will direct the request to your dermatologist. Your doctor will review the prescription request and if a refill can be sent to your pharmacy we will send it electronically. Please allow 3 business days to process your request.
    • Note: if a refill requires a visit before dispensing, we will contact you to make an appointment.
    • You will be contacted by us only if there is a problem with your refill.
    • For any questions regarding the completion of your refill, please contact your pharmacy directly.
    • Prescriptions will not be sent in on weekends or holidays.

    This form is for prescription refill requests only. If you have any other questions, please call or message us.


    When you submit, your form will be sent to a HIPAA secure account.