Lee Side Wellness, LLC
7577 Central Parke Blvd • Suite 113 • Mason, OH 45040
74 Remick Blvd • Springboro, OH 45066
Phone: 513-204-1910 • Fax: 513-204-0049

Lee Side Wellness, LLC

Request a Prescription Refill

Prescription Refill Policy

  1. To ensure quality of care, regular follow up with routine office visits is necessary for prescriptions to be provided.
  2. If two or more scheduled office visits have been missed, or the time since last visit exceeds 90 days, the provider must be seen before any prescriptions are written.
  3. Please inform your provider about needed refills at least 3 business days before your medication runs out. Set aside an emergency reserve of 3 to 5 days of each prescription.

Online Request Form

Please complete the secure form below to request a prescription refill from your provider at Lee Side Wellness.

Patient Information
Name:
Date of Birth:
Home Phone:
Cell Phone:
Preferred Contact Method: Home Phone
Cell Phone
Prescription Information
Who is your Precribing Provider?
Medication Requested:
Medication Dosage:
Medication Frequency:
Pharmacy Name:
Preferred Telephone:
Question/Comment: