What is your question?
Patient Name (if different)
Phone number where you can be reached*
Date of Birth:
Your Pharmacy's Phone Number:
* Required Fields
By submitting this form I agree that this question is a non emergency and can be answered within the next 24 to 48 hours during the business week. I will make an appointment or come to the emergency room for all questions not recently evaluated by a physician.
Please type the characters you see.