Request Prescription Refills

Use form below for prescription refills.

Please complete the secure form below and press submit. If there is a problem with your prescription refill request or we require more information from you, we will contact you by phone.

 

All requests will be processed within 24 – 48 hours during regular business hours, Monday – Friday, 8:30 am – 5:00 pm, excluding holidays. If you require an immediate refill or have a question, please contact our office.

 

Please complete the following information in its entirety.

Request Prescription Refills
  • Please Note: Controlled substances cannot be called in. These prescriptions must be mailed or picked up.
  • Prescription #1
  • Prescription #2
  • Pharmacy information

    Please tell us which pharmacy you would like us to call your prescription into. Please be precise as there are many pharmacies and pharmacy locations.

    • gform 11 Submit

    * Required Fields

    building logo

    Our offices across Long Island are open for in-person visits with new protocols for immediate, personalized care in the safest possible environment.

    Learn More learn-more-arrow

    How we helped our patients feel better.

    Read Patient Reviews learn-more-arrow Share Your Story learn-more-arrow
    • Amanda Moore

      "I dislocated my shoulder working out in January. I was not able to even put my arm above 45 degrees. ...

      Amanda Moore

      Procedure

      Physical Therapy

      Performed By

    • John Piccarelli

      "While years as a professional surfer and snowboarder have taken a physical toll on me, I credit Orlin ...

      John Piccarelli

      Procedure

      Knee Reconstruction, Knee Surgery, Birmingham Hip Resurfacing

      Performed By

      Craig Levitz, M.D.,Eric Price, M.D.,Bradley Gerber, M.D.

    • Paul Scaley

      "Unfortunately, my MRI test results confirmed Dr. Mallo's suspicions. I will need a shoulder replacement. ...

      Paul Scaley

      Procedure

      Acute severe left shoulder TRC

      Performed By

      Gregory C. Mallo, M.D., F.A.A.O.S.

    Hero Shape

    * Required Fields