Last Update:
Dec 19, 2017.
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To Request Prescription Refills by Fax:
Print the Prescription Refill Request Form: RxRefill.pdf.
Complete the form.
Then, Fax it to (616) 774-0304

1) Do NOT use for Emergencies (Instead: Dial 911 or call us at 774-8200).
2) All submissions are individually reviewed.
3) Only registered patient’s requests will be honored.
4) Controlled substances will not be refilled (Instead: call us at 774-8200).
5) Prescriptions will be processed by the end of the NEXT BUSINESS DAY.
6) Refill requests submitted on nights, weekends and holidays
   will be processed the following Monday or Business Day. 
7) Check your Prescription Bottles for Drug Names & Strengths - etc.

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