Prescription Renewal Information

Please do not use this form for emergencies. Call your doctor's office or Dial 911.

Save Time: Call Your Pharmacy First

Whenever possible, we recommend contacting your pharmacy before calling our office or filling out this form.

• Most pharmacies offer refills by phone or online. This is usually the fastest way to get your prescription refilled.
• Even if your prescription has expired or you have no refills remaining, your pharmacy can save you time on renewals by sending an electronic request directly to our office.

When to Use This Form

Use this form when all of the following are true:

• Your pharmacy cannot process your renewal request or you are changing pharmacies.
• You are an established patient. (New patients, please call our office.)
• Your prescription request is non-urgent. Please note that it may take us up to two business days to respond and some prescription renewals require an appointment or additional testing. Please do not wait until you are out of medication.

Proceed to Prescription Renewal Request Form

You will be asked to login to your MyMidMichigan Account or create an account if you don't already have one.