Harrisburg Primary Medical Care












Prescription renewal is reserved for active patients only. Requests for renewals here does not guarantee your request will be granted. The doctor will review your medical records before authorizing any prescription refills. All information requested below must be completed in full in order to fulfill your request. You will be contacted within two business days to confirm your request.

Please fill out all the information below:

Full Name:
Address:
City:
State:
Zip Code:
Phone Number (include area code):
Email Address:
Date of Birth:
Social Security Number:
Pharmacy Name:
Pharmacy Phone Number:
Prescription Refill Requested (copy all information from the prescription label):

    

«  return to top

Home   |   Staff   |   Services   |   Patient Education   |   Office Information   |   FAQ
New Patients   |   Events   |   Survey   |   Links   |   Contact Us

Primary Care Group
117 E Clark
Harrisburg, IL 62946

phone    618-252-8625
fax    618-252-2540
        

Sloan Medical Clinic
7211 US Highway 45
Carrier Mills, IL 62917

phone    618-994-2321
fax    618-994-2034

Copyright © 2008 Primary Care Group | Illinois Primary Care | Harrisburg Primary Medical Care
Web site design and maintenance by Physician Webpages