Prescription Refill Request

Allow at least 7 days notice before you will be out of medication, to prevent disruptions in your medication regimen.

Due to a new state law that extends the time required to write prescriptions for controlled substances there can be no same day refills.

Note that if the patient has not been seen in the office in more than three months, you will be required to schedule an appointment before the refill is authorized.

Online forms are provided as a convenience for patients who choose to use them, and reasonable steps have been taken to secure the form data. If you do not feel comfortable entering your information online, you can print a paper copy of the form (PDF) and either fax it to our office at (914) 560-2106 or bring it to your next appointment.

The fields marked with (*) are required fields.

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