GROVETON FAMILY MEDICAL PATIENT PORTAL

Patient First name * Last name * Patient DOB * Patient Phone Number * Pharmacy - Please specify which location * Medication Refill Request *

Please allow 72 hours for requests on all current medications. An appointment may be required. **we can not fill medications, if we do not have it on file** NO controlled medications will be refilled- must call us to request refill 936-642-0841

Provider *