Mental Health Medication Refill Request Form

Please fill out the following form in its entirety. Please be sure to provide contact information where you can be reached in case there are any questions regarding your request.

When you are finished, please click the Submit button.


Dear Valued Patients, We wish to inform you of a recent change on our website. Due to a technical glitch that was preventing some refill requests from reaching our staff, we have taken the decision to delete the Medication Refill Request Form entirely for the time being. To ensure that your medication needs are addressed promptly and accurately, we request that you directly email our dedicated nursing staff. For medication refills, please reach out to us at: 📧 We apologize for any inconvenience this may cause and appreciate your understanding as we work towards a more reliable solution. Your health and well-being remain our top priorities, and we continue to be committed to providing you with the highest level of care. Thank you for choosing Strategic Mental Health for your healthcare needs. If you have any questions or require further assistance, please don't hesitate to reach out to us. Warm regards, The Strategic Mental Health Team