Please note:
- Please properly fill out the form completely with accurate and complete information. It is a requirement for us to contact you to validate the request. We will not submit the refill request without someone from our clinic first contacting you to confirm your refill request.
- We will also contact you in the event that we find a problem with your refill request.
- None of the information that you submit through this website is saved. In compliance with online Medical Regulations, all information is directly delivered to the clinic and then destroyed/deleted. Record of each transaction is noted in the patient’s file/record keeping system. Please contact our clinic if you have any questions regarding this online Prescription Refill Request Form.
Before you make a request:
This prescription refill request form is for existing active patients of Greeg Family Healthcare Clinic. Please feel free to call us directly at (575) 532-5700 if you happen to have any questions regarding this form.
How this works
- If you have been seen within the past 3 months, and wish to submit a Prescription Refill Request, you may do so by filling out this form.
- Please fill out the form correctly with the correct & accurate information/details.
- One of our staff members will review your request within 24 hours and forward it to our medical staff for a final determination.
- We will call you to discuss the outcome of your request.
- Please note that if it has been more than 3 months since your last visit, we might ask you to first schedule an appointment to come in to be seen at the clinic before we can refill your prescription.
- Please also note that refill requests for Controlled Substances will not be processed without a face-to-face contact with our provider.
- If you do not receive a call from the clinic within 24 hours of your request, regarding your Prescription Refill Request, please call us directly at (575) 532-5700
- If you are submitting your request after official clinic hours on Friday or sometime over the weekend, please allow until Monday for us to process your request.
- If you have an urgent request that cannot wait, please feel free to contact us directly via phone at (575) 532-5700
- Please make sure that you provide us with the correct phone number, where we can call you at, once we have a chance. Upon our 4th attempt to call you, we will leave a message that we have attempted to contact/call you. We will only hold on to your request for up to 24 hours from our 4th call attempt, and then we will just discard/delete your request. Thereafter, you will either need to call-in your request via phone, or if your request is not for an urgent need…you can re-submit another request online.
- WE WILL NOT REPLY TO YOU VIA EMAIL. In compliance with Federal Medical Rules/Laws & Regulations, and as part of our clinic’s practice & policies, we will not communicate with you via e-mail. The only email that you can ever get from this system is an e-mail copy of your submitted request online. Please feel free to ask our staff if you have any questions about this on your next visit to our clinic.
Please note:
- Please properly fill out the form completely with accurate and complete information. It is a requirement for us to contact you to validate the request. We will not submit the refill request without someone from our clinic first contacting you to confirm your refill request.
- We will also contact you in the event that we find a problem with your refill request.
- None of the information that you submit through this website is saved. In compliance with online Medical Regulations, all information is directly delivered to the clinic and then destroyed/deleted. Record of each transaction is noted in the patient’s file/record keeping system. Please contact our clinic if you have any questions regarding this online Prescription Refill Request Form.
English