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HEAL * RESTORE * EQUIP
Dr. Wendy Vandemark, M.D., Co-Founder/Co-Owner
Katherine Freeman, LCSW, Co-Founder/Co-Owner
MEDICATION REQUEST FORM
ATTENTION:
The nurses have 24 -- 48hrs to review and respond to ANY requests during normal business hours.
All requests received after11:55AM on a Friday will be processed the following MONDAY during normal business hours.
[This includes ALL requests submitted on Saturday & Sunday.]
Please submit ONE form for all the medications to be refilled. This form can also be used to communicate any concerns/issues to your provider.
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