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Request a Prescription Refill

PLEASE NOTE:
 

  • If it is more than 3 months since your last appointment at WAVES, you may need to schedule a consult before your medication can be refilled.
     
  • Please note that it will take a minimum of 3 business/weekdays to process your request. If the information below is incomplete, processing your request may be delayed.
     
  • If you have run out of medication and this is now an emergency, please contact client services by calling 778-432-4322 for more information.

 

 

Today

CLIENT INFORMATION

 

PATIENT INFORMATION

 

PATIENT HISTORY

 


If it is more than 3 months since your last appointment at WAVES, you may need to schedule a consult before your medication can be refilled.






REQUESTED REFILLS

 

 
Medication
 
Medication Strength
(e.g. mg, g)
Current Dose
(e.g. 1 tablet three times a day)
Amount Requested
(e.g. 30 days)
How much medication
remaining?
 1. 
 2. 
 3.
 4.
 5.
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