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 include City, State, and Zip-code
Please note: Requests will be resolved within 72 hours. All prescriptions are electronic and will be sent directly to your pharmacy.