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Refill Request Form

Please submit through our new website at https://www.fhwak.com/refill

or click HERE

​

1)  Client Information

2)  Clinical Information

Note: To determine safety, efficacy and quantity FHS requires that a follow-up appointment be in place for all refill requests.  If you don't have an appointment, then please click the link below to scheudle one now.  

Schedule Your
Appointment

3)  Prescription Info

Click HERE for a list of local Pharmacies

Please note: Schedule II medications such as Adderall, Concerta, Ritalin, Vyvanse, Focalin, Dexadrine, etc CAN NOT BE CALLED INTO A PHARMACY.  We will inform you when this category of prescription is ready to be picked up at reception.

4)  Confirm and Submit!

Please Submit Requests One Medication at a Time.

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