Medication Refill Request Form

For Existing LiveActive Members

Quick Notes:

  • Please allow 2 business days for refills.

  • If picking up refills at our office, you will receive a text when meds are ready for pick-up.

  • We will process your payment when you arrive to pick up your medications, but if medications are not picked up within 7 days,
    your card on file will be processed on your auto-charge date.

  • We are unable to return meds once dispensed.

​We are passionate about practicing medicine the way it should be.

Thank you for choosing LiveActive Health.