Did You Know?

You can also contact your local pharmacy to get your prescription refilled. If you have a refill available, they will fill it for you to pick up.

If you don't have any refills available, your pharmacy will contact us to issue a refill. We will check your medical records and refill your medication or contact you to explain why we can not.

Prescription Request

Endocrine Metabolic Medical Center offers its established patients the ability to request a new prescription, or a prescription refill, online.  Please fill in all the fields below.  We need all this information, and for it to be accurate, in order to process your request.

Patient First Name
Patient Last Name
Date of Birth
Phone Number
Email Address
 
Pharmacy Name
Pharmacy City
Pharmacy Phone
Pharmacy Fax
   
Medication
How often you take it:
Medication
How often you take it:
Is this mail order?
If yes, ID number:
Mail Order Phone
Mail Order Fax
Comments

More questions? Please contact us.