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
 
 
  Bipolar Disorder
 
 
  Insomnia and Stress
 
 
  Obsessive Compulsive Disorder (OCD)
 
 
  Other Emotional Disorders
 
 
  Schizophrenia
 
  CHRONIC DISEASE MANAGEMENT  
 
  Autoimmune diseases
 
 
  Cancer
 
 
  Neurological 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) Testing
 
 
  Supplement Evaluation and Planning
 
 
  Weight Management Programs
 
 
 
  Contact Us  
  Tranquil Health Center
Suite 130
1833 West Main Street
Mesa
AZ 85201
623-242-2698		  
  Drlindand@gmail.com  
 
 
@2010 Tranquil Health Center, Suite 130, 1833 West Main Street, Mesa, AZ 85201, Mesa, AZ, 623-242-2698, Drlindand@gmail.com