Prescription Refills
Prescription Refill Request
To request a prescription refill, please contact our registered nurse, Michelle Ridgeway. She may be reached directly at (515) 776-7859 or through our main line, at (515) 499-4959 (select “pharmacies”). Our fax number is (515) 870-2223. Michelle is also ready to help answer any general medical questions you may have.
Our Refill Policy
Please complete the form below when you have one week’s supply of your prescription left.
Please allow up to 72 hours for your request to be honored and up to 5 business days for any prior authorization requests.
We do not guarantee approval of all requests. If you’ve missed appointments, you may be asked to schedule an appointment so that we may provide safe and helpful care and comply with federal and state prescription regulations.
Emergencies
We try our best to accommodate emergency refill requests as quickly as possible.
HIPAA Release Form
Please sign the HIPAA release form to allow us to communicate your medication refill needs.
Policies & Tips
Take a look at the PDF explaining our prescription policies, helpful tips to keep in mind for medication appointment(s), and more.
GeneSight Testing
Our genetics could play a part in how our bodies react to medication. If you’ve experienced negative side effects or noticed that certain prescriptions simply don’t work for you, GeneSight Testing may be worth exploring. A DNA sample is taken by swabbing the inside of your cheek and you’ll receive a comprehensive report on what medications might be less likely to be effective, require dosage adjustments, and have the potential to cause adverse side effects.
Contact Bloom Women's Wellness
Payments Accepted
We accept Wellmark Blue Cross Blue Shield, Anthem, Midland’s Choice, Cigna, Health Partners, and private pay clients. We believe that mental health care should be accessible and we’re happy to work with you on a sliding fee scale.