I understand that refill requests are available only for established patients of Amphyst Behavioral Health and may take 1–3 business days to process. Submission of a refill request does not guarantee that a prescription will be renewed; my provider may require an appointment, additional information, or other clinical follow-up before authorizing a refill.
For patients under age 18 and for patients prescribed a controlled substance (such as stimulants, benzodiazepines, or sedative-hypnotics), the patient must have been seen by their PMHNP within the past 3 months. Adult patients age 18 and older requesting non-controlled medications must have been seen within the past 6 months.
If follow-up is due or a required appointment is not scheduled, Amphyst staff may contact the patient or parent/legal guardian to arrange an appointment before the refill request is forwarded to the provider.
This form is for routine refill requests only and is not monitored for urgent or emergency concerns. For a psychiatric or medical emergency, call 911 or go to the nearest emergency department.