Using your current prescription bottles, please provide us with the information requested below to place a refill request.
This form is only for patients that use Palms Medical Group pharmacies.
If you use an outside pharmacy, please contact that pharmacy directly regarding refills. If you need to fill a new prescription please contact one of our pharmacy locations.
To make an appointment at any location, or to speak with a Financial Services Specialist please call 1-888-730-2374
Palms Medical Group is a FTCA Deemed Facility.
This institution is an equal opportunity provider and employer.
This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.
This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). Palmsmg.org uses webforms on this site. These forms require users to give contact information. Contact information from the registration form is used only to send material relating to the event for which it was collected and will not be sold to another party. Palms Medical Group will not disclose, without your consent, personal information collected about you, except for certain explicit circumstances in which disclosure is required by law. Palms Medical Group will not distribute or sell personal information to third-party organizations.
Notice of Privacy Practices | Patient Bill of Rights
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