Prescription Refills


The above link will take you to a secure form to submit refill requests.  You will be returned to this website afterwards.  If you need to submit more than 3 medications please fill out the form a second time.  You may also click here.


In order to expedite this request, please make sure to provide your pharmacy's phone number AND fax number. If you do not know the fax number, please call your pharmacy to obtain it prior to completing this form.


T: 703-560-3510   F: 703-876-0253

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