If you are in need of a medication, previously prescribed by one of our providers at Health Partners Free Clinic, please call us at (937) 332-0894 during regular office hours or by completing and submitting the form below.
Please request your refills before you run out! We suggest you make your request 10 to 14 days before you run out. Our purpose for this advance request is to allow us extra time make sure you receive your medication in a timely manner.
If you received your medication from St. Vincent Charitable Pharmacy, then please be sure to follow the instructions on the bag handed to you in order to obtain a refill on medications.
You may submit requested refills in the space below. We will respond to you as soon as possible.
