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.

  • Date Format: MM slash DD slash YYYY
  • 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.

  • Pharmacy Address * Required

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What Our Patients Are Saying

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  • "I first used Dr. Keefer in 1998 for a torn rotator cuff. He had been recommended by my internist, Dr. ...

    Sondra Blum

    Procedure

    Rotator Cuff Surgery and Hip Surgery

    Performed By

    Eric P. Keefer, M.D.

  • GaryRieselsmallfile_150x150_acf_cropped_150x150_acf_cropped
    "My first visit to Orlin & Cohen was to see Dr. Garroway after injuring my right shoulder. He was ...

    Gary Riesel

    Procedure

    Shoulder Surgery, Physical Therapy

    Performed By

    Eric Price, M.D.,Robert Y. Garroway, M.D.

  • "I came to Orlin & Cohen after a car accident 5 1/2 years ago that left me with multiple herniated ...

    Laurie Jackson

    Procedure

    Pain Management

    Performed By

    Alfred F. Faust, M.D.,Daniel Yadegar, M.D.

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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.
To schedule a new in-office or telehealth appointment, please fill out the form below. We will respond as quickly as possible. To request a follow-up appointment, click here.

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