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Refill Request for Established Patients Only
- You must be an established patient to complete an online refill request.
- Submit requests at least 3-5 days prior to running out of medication
- Requests will only be approved if you are no more than 5 days early
- Allow 48 hours for refills to be processed
- Refills requested on Saturday or Sunday will be processed the following business day.
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Financial Agreement
I agree to pay in full for all services rendered after completing this progress report. There will not be any refund if medication is left at the pharmacy for longer than 7 days. There will not be a refund for lost or stolen medication. There will not be a refund if the pharmacy denies the prescription due to no fault of Get Well Clinic. There will not be a refund if you change your mind about continuing the program.
Medically Supervised Program 1 |
$50 |
Medically Supervised Program 2 |
$100 |
Lipo-C/ B12 Injection Bundle (must pick up in office) |
$50 |
Hcg Program 23 Day (syringes) (must pick up in office) |
$125 |
Telemedicine Visit |
$125 |
Call 832-781-4340 before making payment