Phone: 623-242-2698
   
 

RX Refill Request
   
 
 
Name of the Patient:  
     
Date Of Birth:  
     
E-Mail:  
     
Name of the Medicine:  
     
Dose:  
     
How often:  
     
Name of the Pharmacy  
     
Address of the Pharmacy: (optional)  
     
Phone number of the Pharmacy:  
     
Fax number of the Pharmacy  
     
   
   
 
 
  Medical Services  
  MENTAL/EMOTIONAL HEALTH  
 
  ADHD
 
 
  Anxiety and Depression
 
 
  Insomnia and Stress
 
 
  Other Emotional Disorders
 
  PAIN MANAGEMENT  
  ANTI- AGING MEDICINE  
 
  Bioidentical Hormone Balance
 
 
  Neurotransmitter, Metabolic and Hormonal Testing
 
  WELLNESS AND PREVENTATIVE MEDICINE  
 
  Comprehensive Exams and Medical testing
 
 
  Dietary Counseling
 
 
  Psychosomatic Energetics (PSE) and testing
 
 
  Supplement Evaluation and Planning
 
 
  Weight Management Programs
 
 
 
  Contact Us  
  Tranquil Health Center
Mesa Mansion Suites
Suite 3
86 West University Drive
Mesa
AZ 85201
623-242-2698		  
  Drlindand@gmail.com  
 
 
@2010 Tranquil Health Center, Mesa Mansion Suites, Suite 3, 86 West University Drive, Mesa, AZ 85201, Mesa, AZ, 623-242-2698, Drlindand@gmail.com