Medication and Prescription Refills
Your name:
Date of Birth:
Email address:
Home Phone number:
Pharmacy Name
Pharmacy
Phone Number:
Comments:
Tired of losing the little slips of paper you get at the doctors office?  
Why not get your prescriptions filled electronically?  
Getting your prescriptions to your neighborhood pharmacy is as easy as 1-2-3!
We can send your prescriptions to
CVS, Walgreens, Walmart or any pharmacy.
Simply fill out the form below.
Make sure to include your pharmacy address and telephone number.  
You will be contacted to confirm the medications and pharmacy information.
HOUSTON SPACE CITY DOCTORS
Charles A. Garcia, M.D., P.A.
Exceptional Eye Care in Houston
Downtown  (713) 659-3937  Museum District (713-333-0151
East Houston Eye Center  (713) 453-3521  
Webster/Clear Lake  (281) 332-1559 Bellaire (713) 668-7337