Prescription Refill Request

If you are a current patient and require a prescription refill, please fill out the form below to send a confidential message. All communication, including patient information, will be kept confidential and secure. 


We appreciate your continued cooperation and will respond to your request within 72 hours.

Office Hours: 10:00am-5:30 pm | Telemedicine Hours: 10:00am-5:30pm

Location: 5930 Lovers Lane, Portage MI 49002

Phone: (269) 381-6950 | Fax: +1 (866) 898-9349