Birmingham Internal Medicine Associates, PC Medication Refills

Medication Refills

Please Note: this is for ROUTINE Medications Refills ONLY. If you are not current with your visits or labs, please contact our office for an appointment.

If you are sick, please do not email us. Please contact the office by phone.

Please contact your pharmacy to see if your prescription is ready for pick up. We will only contact you if there is a problem and have NOT phoned in your prescription. Thank you.

For your convenience, we are happy to provide you with prescription refills prior to your next appointment. Any request for a prescription refils received by will be processed by the end of the next business day. Prescriptions requested on Friday after 12:00 pm or over the weekend will be available on Monday after 12:00 p.m. We ask that you do not wait until your prescription has run out before requesting a refill. You must provide all the following information to ensure that your request can be processed. Accuracy of information is very important. If you experience any difficulty using this service, please call our office. As always, we ask that you bring all of your medication bottles with you to your appointments so that we may verify that you are receiving the correct medications.

If you are requesting this during a holiday period, your request will be taken care of the next BUSINESS day.

**** PLEASE DO NOT DUPLICATE YOUR REQUEST BY CALLING AND REQUESTING YOUR REFILLS VIA EMAIL, PHONE & through your PHARMACY. WE ASK THAT YOU UTILIZE ONLY ONE METHOD.

Patient Full Name:
Birth Date (month, day, year):
Phone Number:
Email Address:
Primary Physician:
Pharmacy Name & City:
Pharmacy Phone Number (enter
Medication #1:
Dosage (mg-ml-etc.):
How Often:
Route Given:
Quantity:
Refills:
Medication #2:	None
Dosage (mg-ml-etc.):
How Often:
Route Given:
Quantity:
Refills:
Medication #3:	None
Dosage (mg-ml-etc.):
How Often:
Route Given:
Quantitiy:
Refills:

PLEASE READ THE FOLLOWING BEFORE SENDING YOUR REFILL REQUEST.

The sending and/or receiving of the e-mail request DOES NOT establish a doctor-patient relationship nor does it serve as doctor-patient communication where that relationship has been established. There can be no guarantee that your e-mail will be received or acted on in any way. If you have a medical question or need to obtain information from anyone associated with our practice, you should contact us via telephone or in person rather than by email. Additionally, Birmingham Internal Medicine Associates, P.C., and its physicians DO NOT give advice to patients or potential patients via e-mail.