Better Women's Care
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    Medication Refill Request

    Please allow 24 - 48 hours for refills to be processed. Please do not submit via website and call the office as it may delay your refill being processed. Please DO NOT use this form to make or cancel appointments. Thank You!

    enter as mm/dd/yyyy
    Example: Motrin 500 mg
    Example: Motrin 500mg, Qty 30, CVS 248-353-9898
Submit
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