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.

  • 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

* Required Fields

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

What Our Patients Are Saying

View Patient Reviews learn-more-arrow
  • JamesDavidesmallfile_150x150_acf_cropped
    "Choosing Dr. Price came about by a combination of events. First, my training facility recommended him ...

    John Davide

    Procedure

    Rotator Cuff Surgery

    Performed By

    Eric Price, M.D.

  • "Dr. Ticker performed my shoulder surgery re-attaching and repairing torn tendons in both my rotator cuff ...

    Ken Hehir

    Procedure

    Rotator Cuff Surgery, Bicep Surgery

    Performed By

    Jonathan B. Ticker, M.D.

  • "For many years, we have been bothered by chronic knee pain. This was becoming progressively worse as ...

    Lauranne & Barry Turgen

    Procedure

    Knee Replacement Surgery

    Performed By

    James A. Germano, M.D.

New
Appointment Follow-Up
Appointment
Hero Shape

Request an Appointment

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.

* Required Fields

Please complete the form below and someone from our billing department will call you shortly to complete your payment over the phone.

* Required Fields