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For current patients

Request a prescription refill

Already a Lifespan patient? Submit your refill request below and our team will process it promptly. For urgent needs, please call us directly at (850) 999-2996.

Name
Please list each medication and dosage, your prescribing provider, and your preferred pharmacy (name & location). This form is not for emergencies — call 911 or 988 if urgent.

Please allow 48–72 hours

Refill requests are typically processed within 2–3 business days. Please submit before you run out of medication. Controlled substances may require an appointment.

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