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ADHD Medication Refill Request

Request a Refill of ADHD Medication
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GUIDELINES:
  • Please request medication refills at least 7 days prior to needing to pick it up.
  • We will do our best to process your request within 48 hours during week days.
  • We DO NOT refill medications over the weekends.
  • Please DO NOT come to the Royal Palm Beach office on the weekends to pick-up prescriptions
YOUR CHILD IS REQUIRED TO HAVE A YEARLY WELL EXAM IN ORDER TO BE PRESCRIBED THESE MEDICATIONS.
Please select your primary office:
Name:
Birthdate:
Name of Medication:
Dose:
Is this a 90-day mail order refill?
Name:
Telephone Number:
E-Mail Address:
Preferred method of contact for confirmation: