Weight LossRefills

This form is for existing Vitality Health & Wellness patients requesting prescription refills.

All requests require provider review and approval. Please allow 48 hours for processing. An appointment or updated labs may be required before a refill can be approved.

This form is not monitored for urgent concerns or emergencies. For a medical emergency, call 911.

Please note: This form will not automatically place medication orders.

You will be sent an invoice when the order is approved by the provider. This invoice must be paid before we will order your medication from the pharmacy unless other arrangements have been discussed.