Presciption Refill Policy

Medications, Contact Lens, Eyeglasses

Prescription refills are processed during regular office hours. When you complete the on-line form below, your request will be reviewed by your treating physician.

If we have any questions regarding your request, a patient care representative will contact you.

Your request will generally be processed within 4 business hours. Requests received after 4:30 pm will be processed the following business day.

If this is an urgent request, please contact a patient care representative at 713-798-6100.

General Information:
Name
Date of Birth
Today's Date
Phone Number
Address
City
State
Zip
Country
For Medications:
The most convenient way to refill a medication prescription is to call your pharmacist with the prescription number. The pharmacist will contact our office for physician approval. If you prefer to submit your refill request directly to our office, please complete the following information.
Physician Name
Pharmacy Name
Pharmacy Phone Number
Name of Medication
Dosage
Please mail the new prescription to the address above.
Please call my pharmacy with the new prescription.
For Contacts:
If you need contact lenses, how many boxes/lenses do you need?
When my contact lens order has been filled, please contact me by:
phone email
For Eyeglasses:
Please check here if you need your eyeglasses prescription mailed to the address provided on this form:

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Presciption Refill Policy

General Information:

For Medications:

For Contacts:

For Eyeglasses: