Get Refill Request Form For Controlled Substances - Carolinashealthcare

Filling out the Refill Request Form for Controlled Substances is an important step for users seeking to obtain a medication refill. This guide will provide clear, step-by-step instructions to help make the process straightforward and efficient.

Follow the steps to successfully complete your refill request form.

1. Click the ‘Get Form’ button to obtain the refill request form and open it in your document editor.
2. Begin filling out the form by entering the child's proper name and date of birth in the designated fields, avoiding any nicknames.
3. Next, input the parent’s name, phone number, and address, ensuring that these details are accurate for communication purposes.
4. In the medication section, list the name of the medication that requires a refill, along with its dosage and administration instructions.
5. Review the note included in the form. If there are issues with current medication, contact the office directly instead of submitting this form.
6. Complete the declaration regarding the request for a 90-day refill if required by insurance, as well as filling out any additional required information.
7. Ensure that all sections of the form are completed before moving on. If necessary, use the yellow envelope provided to return the form along with a self-addressed stamped envelope.
8. Submit the completed form by following the outlined submission process. Expect to receive a new prescription in the mail within two weeks.
9. Finally, remember to schedule a follow-up appointment 6 to 8 weeks prior to when it is due, as it is required at least every six months.

Take the next step by filling out your refill request form online today.