Refill Requests
Please complete the form below in its entirety to request a medication
refill. Allow 72 hours for processing and completing/ responding to a
refill request. This is for refills of medications you currently are taking,
according to your office record.
Most medical conditions require close monitoring in the setting of an
office evaluation. This may entail evaluating its efficacy, discussing
possible side effects you may be experiencing, discussing new
evidence for alternative medicatoins/therapies for your condition,
and/or laboratory testing to monitor effects. If you have not been in
the office for such in a defined period of time, your request for refill
may be denied pending an office visit. Ideally, medications are
provided at your office visit with enough refills to last to the next
expected appointment. While in any office visit, please remember to
ask for refills of any medications you might run out of before your next
appointment.
PLEASE NOTE: this form is transmitted via NON SECURE EMAIL. If you
have personal concerns regarding the security of your request, please
make your refill request by calling the office and leaving a message
with the office staff, or by contacting your pharmacy and they will
submit a request on your behalf. Do not use online requests for
urgent issues, nor for new prescriptions.
Please complete the form below in its entirety to request a medication
refill. Allow 72 hours for processing and completing/ responding to a
refill request. This is for refills of medications you currently are taking,
according to your office record.
Most medical conditions require close monitoring in the setting of an
office evaluation. This may entail evaluating its efficacy, discussing
possible side effects you may be experiencing, discussing new
evidence for alternative medicatoins/therapies for your condition,
and/or laboratory testing to monitor effects. If you have not been in
the office for such in a defined period of time, your request for refill
may be denied pending an office visit. Ideally, medications are
provided at your office visit with enough refills to last to the next
expected appointment. While in any office visit, please remember to
ask for refills of any medications you might run out of before your next
appointment.
PLEASE NOTE: this form is transmitted via NON SECURE EMAIL. If you
have personal concerns regarding the security of your request, please
make your refill request by calling the office and leaving a message
with the office staff, or by contacting your pharmacy and they will
submit a request on your behalf. Do not use online requests for
urgent issues, nor for new prescriptions.
Family Medicine Associates of Randolph
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121 Center Grove Rd. Randolph, NJ 07869 phone (973) 939-4016 fax (973) 328-0230 fmar@onebox.com