I Need to Refill My Prescription

To request a refill for your prescription please call (319) 626-3300 and select Option 1 or use the form below.

If you have not already done so, please update your insurance information for 2021 with our office staff. Click here for contact information.

Month / Date / Year
Please list the name of the medication you need to be refilled. (e.g. Medication, 20 mg)
Please list the names of any additional medications you need to be refilled (e.g. Medication, 20 mg)
Please note: Requests will be resolved within 72 hours. All prescriptions are electronic and will be sent directly to your pharmacy.