Live: Updated Streu's Rx Refill (Existing Patients Only)

ADMIN ONLY: Processed?

Is this for a patient residing in a Long-Term Care Facility?

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

PLEASE NOTE: If you do not have the RX number, you will need the enter the patient name and drug needed.

Facility Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Prescription Number(s)

Please enter a prescription ID number for each refill you need - one per line. Please enter any other relevant information here as well. Thank you!