We understand that there may be times when patients will need refills of
medications. We will attempt to accommodate refill requests. We reserve the right
to deny refill requests.
Please read the Instructions for Medication Refills prior
to filling out form.
Instructions for Medication Refills
Please have your pharmacy fax medication refill request to our office.

If you need medication called into a different pharmacy, please leave number, your
date of birth, pharmacy phone number specific medications, medication dosing,
and reason on our voice mail or online request form.

If you need refill of medications that requires a controlled substance prescription,
please leave your name, your contact number, and specific medication on our
voice mail or online request form.
Instructions for Prior Authorization of Medications
Unfortunately, not all insurance companies will approve some of the medications
used by psychiatrists. Medications that commonly require Please understand that
we may not be able to get the approval right away.

Please have your pharmacy fax the prior authorization request to our office to
initiate the process.
Patient's name:
Your name:
(if different from patient)
Your email address:
Your phone number:
Patient's date of birth:
Pharmacy phone:
Specific medication refill needs:
Medication Refills
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Frank Chen, MD, PA
2180 North Loop West, Suite 450, Houston, TX 77018
Ph: 832-384-1560 Fax: 832-384-1585
© 2011 Frank Chen, MD, PA

Please give detailed information in order to expedite response.

weekends will be checked on the following business day.