How Do I Submit a Request?

Submit a Request

You may submit a request at any time. Online request forms are available 24/7. 

Select the option below that best matches your needs. Each title links directly to the appropriate form:

• Medication Refill Request
  • For prescription refills, pharmacy transfers, alternative prescriptions, or reporting lost/stolen medications.
• Scheduling Assistance
  • For canceling or rescheduling an appointment, or resolving Zoom-related issues.
• Documentation Request
  • For requesting medical records, accommodations or medical letters.
• Prior Authorization Request
  • For insurance authorization related to a prescription.
• Vitals Reporting
  • For submitting vitals from a past appointment.
• Side Effect Reporting
  • For reporting adverse reactions or side effects.
• Non-Urgent Medical Question
  • For questions about assessments, educational resources, or treatment options.
• Billing Support Request
  • For itemized receipts, payment plans, or refund inquiries.
• Other Questions or Comments
  • For patient portal assistance or general questions.

Phone or Live Chat

Have a question first? Our team is happy to help answer questions by phone or chat before you submit your request!

• Phone: [phone], Monday–Friday, 9:00 AM–5:00 PM EDT
• Chat: Available 24/7 on our website — type "talk to a human" during business hours to connect with our team