Please Read the Information Below Fully Before Filling out the Medication Refill Form
Please allow a maximum of 3 business days to send the prescription to your preferred pharmacy. Your insurance will be billed for medication refill requests outside of appointment times. If you are not using insurance with Safe Haven Health, you will be charged $50. Appointments are required at least every eight weeks for clients prescribed controlled substances. If you have an overdue payment, refills will not be released until payment is made. There are NO early refills for controlled substances, NO exceptions. For refills of Ketamine or Buprenorphine, a follow-up appointment must be made. Medications can only be filled at Colorado, Maryland, Delaware, Vermont, Virginia, Florida, Oregon, and Connecticut pharmacies. If you have any questions or concerns, call or text 720-637-5809 or email firstname.lastname@example.org.