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Prescription Refill Request Form

Prescription refill requests will only be considered for patients/clients who have an established medical relationship with our clinic within the last 12 months. Submit a prescription refill request by filling out the form below. If you have any questions, please don’t hesitate to give us a call at 780-542-2144.

IMPORTANT: Prescription orders are not confirmed until you have received notification. A staff member will contact you by phone or email.

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