Creekmore Clinic Family Practice - Providing Healthcare for the Entire Family home about us services medical staff insurance directions contact us

Our Directory


More About Us

List of Medical Services

Meet Our Medical Staff

Have an Insurance Question

Pre-Approved Insurance Carriers

Frequently Asked Questions

Make a Credit Card Payment

Make a Refill Request

Schedule an Appointment

Re-Schedule an Appointment

Patient Education Area

Medical Forms

Directions to Our Facility

Additional Resource Links

We accept credit cards.

Prescription Refill Request


To order refills online, complete the order form below. You will need your prescription number, which can be found on your original order's packing slip or on your prescription label.

This form is only for existing prescriptions filled by Creekmore Clinic. If your existing prescription indicates it was filled by another clinic or pharmacy, please call the phone number listed on your prescription.

*Full Name:
Address:
City:
State:
Zip:
Contact Phone:
*Email:
Pharmacy Name:
Drug Name:
Dosage:
Prescribing Physician: