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Available Forms

NURSE MESSAGE FORM

Tranquility BHC NURSE MESSAGE FORM

Please provide us with any medication management issues or problems with the medications. If you are having negative side effects, please tell us in detail what is going on. if you are experiencing a life threatening reaction to the medications, please call 911 or proceed to the nearest ER.
If you are in need of medication refills, please fill out designated Refill Request Form.
 
 

If answered yes, please go to the nearest Emergency Room or call the office directly AFTER submitting this form.

 

All nurse messages submitted before 4:30 P.M. will be reviewed by the end of the business day of which you originally submitted your request. However, please allow up to 3 business days for any medication requests and pharmacy changes. There is a $15 fee for all Pharmacy changes.

 
 
 
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