Refill Request | Rooted Health

I am needing:

Medications called into my local pharmacy

Medications shipped to my home that I have previously ordered.

if you are needing anything besides these two options you must call us 479-880-6148. Allow 24-48 hrs for a response. Leave a voicemail.

First name

Last name

Date of birth (MM/DD/YYYY)

Phone

Email

Medication/Supplement name (include mg/strength)

We do not refill medications if you have not been seen within 3 months. Please book your appointment online by clicking on our homepage. Controlled substances of any kind require monthly visits. Per policy-We do not write prescriptions for controlled substances for new patients.

Quantity Remaning

The amount of medication you currently have left. Refills should be requested two weeks prior to need.

Pharmacy name + phone (if applicable)

Shipping address (if shipping)

When was your last appointment at Rooted Health?

Never

Less than 3 months ago

Greater than 3 months ago

Comments/ Concerns/ How can we do better? We appreciate you!

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