Prescription Refills
This form is for most prescription refills. Please print out this form and mail or fax it to the office.
Please be aware of the following:
Please have your pharmacy's name, address, telephone and fax number ready.
Complete all information on the form. We will fax the prescription refill to your pharmacy.
Please allow at least 24 hours (excluding weekends) for this process to be complete.
We will notify you when we have faxed the prescription refill to your pharmacy. Please give us a telephone number for you which will accept a message if you are not available.
If a non-Centre Pediatric provider issued your child's original prescription, you must call our office to speak with your primary care provider about this refill.
By law, certain prescription drugs can only be prescribed with an original signature by your provider and we may not be allowed to fax these refills to your pharmacy.
Click here for a printer safe copy which you can complete and mail or fax to us at:
Centre Pediatrics Associates, PC
One Brookline Place
Suite 327
Brookline, MA 02445Fax: (617) 232-0572
