Refill Request Form

Refill Request Form

*Please be Advised

It takes approximately 24 to 48 business hours
for a prescription to be sent to your pharmacy.
Thank you for your patience.

Heights Medical pharmacy discharge program with
Hackensack University Medical Center

A new program in collaboration with the Hackensack University Medical Center Pharmacy and our hospital colleagues has been implemented for all Heights Medical patients admitted to HUMC.

This completely voluntary program insures that our patients receive their medications at or before discharge. In collaboration with your hospital doctor your prescriptions will be written to the pharmacy by your physician at Heights Medical. A representative of the Pharmacy department will provide a full explanation of your medications upon delivery to you at bedside.Every attempt will be made to keep your out-of-pocket costs for prescription medication at the lowest possible by using co-pay savings programs. We hope it will reduce your likelihood of readmission to the hospital, reduce wait times at the pharmacy and increase your satisfaction with Heights Medical and Hackensack University Medical Center.This does not affect your usual pharmacy relationship following discharge and for any refills.Our staff is always ready to assist with any questions you may have.Your health care team at Heights Medical

  • Thomas Bellavia, MD

  • Carl Renner, MD

  • Rebekah Marquis, DO

  • Joyce Feliciano, APN

  • Maria Monda, APN

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