Please call the office to submit clinical information or medication refill requests. If you are in crisis, please call 911 or go to the nearest emergency room. All requests are processed on a first come first served basis and you will get a response in 3-7 business days.

*** This form is for administrative purposes only and is not HIPAA compliant. It cannot be used to submit clinical information, medical refill requests or to seek help during a crisis. All requests are processed on a first come first served basis and you will get a response in 3-7 business days. ***