To submit a request for a prescription, please fill out the form below.

Please remember: Controlled substances (for example, ADHD medicines) cannot be called into pharmacies and must be picked up at the office during normal business hours.

Please allow 3 business days for your request to be handled.

If this is an URGENT prescription refill request, please call our office at 205-333-8222.

By submitting this information, you are agreeing to send your information electronically.

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