Prescription
Refill For Columbia Avenue Office Patients
The
office will check this site each morning between 6:30 and 7:30 am Monday
through Friday. Your
prescription will be available after 48 hours from the time you placed
your request.
Prescriptions requested on Friday after 7:30 am or over the weekend will
be available on Monday after 4pm. Due
to pharmacy guidelines for patients with pharmacy services from Express
Scripts or Merck-Medco,
your prescriptions must now be picked up in the office after 48 hours
from the time of your request.
* Required items.
*Please click on the arrow and select your doctor or nurse practitioner.
1.
*Enter the name of your
first medication in the space provided below.
*Strength or milligrams
*How taken, choose one from list.
If other please specify:
*Number of days supply needed.
Number of refills requested:
2. Enter the name of your second medication in the space provided below.
Strength or milligrams:
How taken:
Number of days supply needed.
Number of refills requested:
3. Enter the name of your third medication in the space provided below.
Strength or milligrams:
How taken:
Number of days supply needed.
Number of refills requested:
*Pharmacy name:
*Pharmacy address,
i.e. Lititz Pike, Manor shopping center :
Pharmacy phone number:
Any additional comments:
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