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 Prescription Refills

This form is ONLY for Dr. Stokan and Caroline Bang patients

with an existing prescription.


Dr. Stokan and Caroline Bang are now set up through the DEA to eScribe medications.  This means patients no longer need to come into the office to pick up written prescriptions.  We still need to receive your requests the same way through our website. We ask for you complete the form and provide us with your pharmacy. Please call your pharmacy for any refill medications.

**Please Note**

 A denial of your request is possible if you have not attended regular follow-up sessions.

Each form has a place for up to 2 medications

Thanks for submitting your request!

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