what you need to know

Prescriptions

It's easiest to request prescriptions and refills during your office visit. (As required by Virginia law, our prescriptions are only valid for one year from the date that they are written.)

If you need a prescription between visits, please complete the form below or call (804) 897-2100 or in the Tri-Cities, call (804) 520-0205. Refills are processed Monday-Friday from 9:00am until 4:00pm.

When you call, ask for the Prescription Hotline, and please speak slowly and clearly. You'll need to leave the following information:

Your complete name, including the spelling of your last name
Your date of birth
The name of the medication, its strength and dosage
Your pharmacy name and telephone number
Your daytime telephone number
Any allergies you have to medications

Please remember that in certain situations, good medical care requires the benefit of a patient examination before a prescription is issued.

Timesaver tip: Be good to yourself and minimize frustration by calling your pharmacy ahead of time to make sure the prescription is ready for you to pick up!

Doctor's Name:
Pharmacy Name *
Pharmacy Phone *
Medication Name *
Medication Strength *
Quantity
First Name *
Last Name *
Date of Birth *	(MM/DD/YYYY)
Address *

City *
State
Zip
Email *
Daytime Phone*
Preferred Method of Response from VPFW	Email Phone Call
Comments

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