Prescription Refill Request

Generally, we will respond to your request within one to two business days. If you require more urgent attention, please call the office, at 781-239-3550 for Suite A or at 781-239-1093 for Suite B, and speak with the receptionist, or, if the voicemail system answers, press 2 to leave a prescription refill request, or press 0 to leave a general message for the receptionist.

If the time since your last visit with your prescribing doctor has been significantly longer than your doctor recommended at your last visit, we may ask you to schedule another appointment before we can refill your prescription.

We can call in a prescription refill for most medications. However, if you are calling for a refill for Ritalin (methylphenidate), Concerta, Metadate, Daytrana, Dexedrine (dextroamphetamine), Adderall, or Vyvanse, please note that these medications cannot be prescribed by telephone. By law, the pharmacy must have a written prescription in order to dispense these medications. You may specify below if you wish to come into the office to pick up the prescription or if you would like us to mail the prescription to you or to your pharmacy.

PLEASE NOTE: Email correspondence through this website is not completely secure at this time. Please DO NOT relay sensitive information if this is of a concern to you. Email messages pass from your computer through a number of servers (computers) on the Internet. While in route and when stored on the servers, waiting for delivery to your computer, these messages could be read by an unauthorized person. This is highly unlikely, yet the possibility is there. We recommend that you use the telephone for sensitive information you wish to keep absolutely private.

Items marked with a * are required information. The medication name and dosage, pharmacy name, pharmacy address, and pharmacy phone number can all be found on your last prescription bottle.

Prescribing Doctor *

Patient's Name *

(Please spell out the patient's first and last name.)

Message From *

(Your full name.)

(Your full email address.)

Your Phone Number *

(Format xxx-xxx-xxxx)

(Phone number where you can be reached during the day. Please include area code.)

Name of Medication *

Dosage

(For example, 0.5 mg, or 200 mg.)

Pharmacy Name *

Pharmacy Town *

Pharmacy Phone Number *

(Format xxx-xxx-xxxx)

How would you like us to handle your prescription refill?

Remember, if you are calling for a refill for Ritalin (methylphenidate), Dexedrine (dextroamphetamine), Adderall, or Concerta, these medications cannot be refilled by telephone. By law, the pharmacy must have a written prescription in order to dispense these medications.

If you have requested that we mail the prescription to your pharmacy, please enter the pharmacy's full mailing address, including zip code.

Pharmacy Address

If you have requested that we mail the prescription to you, please enter your full mailing address, including zip code.

Your Mailing Address

Additional Message (Please limit your message to no more than 150 words.)