Dr. Ben Go, M.D.

Did you know that Dr. Go is also an attorney? Visit www.GoGroupLegal.com or call the LAW OFFICE at 734-362-8008.

YOU CAN ONLY USE THIS PROMPT IF YOU ARE ASKING FOR A REFILL OF YOUR MAINTENANCE MEDICATION (such as for blood pressure, diabetes, thyroid, cholesterol, depression/anxiety, allergies, etc). It takes 1-2 Business Days to fill, if approved. For all others, including antibiotics, please call the clinic.

1. Non-Controlled maintenance prescription refills will generally be allowed if a patient has been seen by Dr. Go within the last 11-months period.

2. Controlled Pain/ Anxiety & Depression/Psych Prescriptions will generally be allowed if a Patient has been seen by Dr. Go within the last 2-months period.

For Faster and Convenient refills, we strongly recommend pharmacist-owned **RxAll PHARMACY located in Suite C, Phone: 734-463-3300

Fill in these details below if you meet any of the 2 criteria above:

Patient Name Patient DOB: Patient Phone Number: Name of Pharmacy: (see note below) Pharmacy Address: Pharmacy Phone Number: Name of Medication: Medication Dose: Medication Dose Frequency:

**If **RxAll is your Pharmacy, you do not have to fill out the rest. Someone at the RxAll Pharmacy will contact you directly about your prescription refill request.