• Rx Refill Request

    Rx Refill Request

    Use the form below to message your PMHNP to request an Rx refill, however, most refills can be completed by contacting your pharmacy first.
  • Refills of controlled substances will most often require a session with your provider.  You can continue to complete this form; however, after completing this form, you can take the next step and book a follow-up session with your provider in the client portal.  

    Click here to access the client portal. 

    Common controlled substances:

    • Adderall
    • Vyvansel
    • Methylphenidate
    • Lisdexamfetamine
    • Xanax
    • Klonopin
    • Alprazolam
    • Clonazepam
    • Ambien
    • Zolpidem
  • Should be Empty: