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Prescription Refill Request Form
Please provide the following information for your refill. The name of the medicine, strength, frequency, days for refill (30 days, 90 days), and the pharmacy. All refills will be submitted in the order they are received. As a reminder, we do not fax in request for Express Scripts. These can be mailed to your home or picked up at the office. Please indicate which you prefer. Antibiotics will not be prescribed without an appointment.

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    Internal Medicine of Southeastern IN

    Dr. Mary Robertson
    1088 N State Road 229
    Batesville, IN 47006
    (812) 933-1858