Step 1 of 18

Refill Options

Refill (1 Medication)

Refill (2 Medication)

Refill (3 Medication)

Refill (4 Medication)

Do you need only ONE medication refilled today?(Required)

Yes, only ONE medication

No, more than One medication

This visit is only for ONE medication, you will NOT be able to select more than one medication here. If you need MORE THAN ONE medication refilled, go back to select the refill option with the amount of medications needed (2, 3, or 4+)

Controlled or Dangerous Rx Notification *(Required)

I understand that Medicspot does NOT prescribe controlled substances or sedating medications such as Xanax, Ambien, Gabapentin, Muscle relaxant, Gabapentin, Opioids, Anabolic Steroids, Testosterone, Clomid, Stimulants like Ritalin or Adderall

We do NOT prescribed controlled drugs

Why is your doctor unable to refill the prescription(s)? *

My doctor's office is closed

I can't afford the doctor's visit

My doctor refused to refill my medication

My doctor requires lab work

I can't get an appointment with my doctor

I do NOT have insurance

Other reason

To establish medical necessity

Provide Information About The First Medication You Need

For 1st Drug: Enter a single medication name with dose and instruction (As written by your doctor)(Required)

Example: Lisinopril 10 mg. Take one tablet every morning)

For 1st Drug: When was the last time a doctor prescribed this medication to you?(Required)

Less than 30 days ago

Within the last 30 to 90 days

3 to 6 months ago

Over 6 months

I have NEVER been prescribed this medication by a doctor

STOP! We're only able to refill medications previously prescribed by you doctor. For initial prescription, please email us at provider@callondoc.com for assistance

For 1st Drug: Are you currently taking this medication?(Required)

Yes, I am currently taking this medication REGULARLY

I take this medication occasionally

I regularly skip doses

No, I am NOT currently on this medication

For 1st Drug: Have you taken this medication today?(Required)

Yes

No, I have NOT taken this medication today

For 1st Drug: When did you last take this medication?(Required)

Yesterday

In the last 2 to 5 days

Over 5 days ago

Over 14 days ago

Over a month ago

Over 3 months ago

I have NEVER been on this medication

STOP! We're only able to refill medications previously prescribed by you doctor. For initial prescription, please email us at provider@callondoc.com for assistance

For 1st Drug: Have you experienced any adverse side effect of this medication?(Required)

No side effects

I have experienced significant side effects

STOP! Remove the medication with adverse side effect to proceed

For 1st Drug: What condition do you treat with this medication?(Required)

Diabetes

Dermatology (Skin, Hair, Nail disorders)

High Cholesterol (Hyperlipidemia)

Hypertension (High blood pressure)

Hypothyroidism

Infection

Leg swelling

Mental health (Psychiatry)

For 1st Drug: Is this medication effective in treating the intended condition?(Required)

Yes, the current dosage is very effective. No medication changes necessary

No, the medication or dosage is NOT very effective

For 1st Drug: Would you consider switching the medication or adjusting the dose?(Required)

Switch to a different medication

Increase the dose

Decrease the dose

I'll let your doctor decide

For 1st Drug: Provide a detailed explanation for the dose change(Required)

Important

Who is the patient?

My Self

Kids

Are you an existing Medicspot patient?

Yes ! Login

No ! I am a New User

Patient's Gender

Male

Female

Name

First Last

Phone

Prescription Refill

Provide Information About The First Medication You Need