Prescription Refills
Sergey Turchin M.D. Internal Medicine
61 Memorial Medical Pkwy Suite 3815
Palm Coast, Fl 32164
Tel: 386-586-1790
Fax: 386-586-1791
Dear Patients,

You can request medication refills on line by completing the form
below. Please allow as least 24-48 hours for our office to review
the request and to make the necessary arrangements.

Thank you.
Middle Initial
Last Name:
First Name:
Date of Birth:
Telephone #:
Medication Name, Dose and
Frequency:
Medication Refill Options
Pharmacy Name and
Telephone Number:
Comments: