Forms for New and Returning Patients

Patients can request forms from their providers by mail, fax, and drop-off.

Mail: Codman Square Health Center, 637 Washington St, Dorchester, MA 02124

Fax:

  • Internal Medicine: 617-825-7118
  • Family Medicine 2: 617-822-8225
  • Family Medicine 3: 617-822-8222
  • Pediatrics: 617-822-8206

Drop-off: Codman’s front lobby has a drop box.

Medical Form Requests

  • Completion Time: 10 business days
  • Pick-up: ID is required to pick up completed medical forms or letters from your provider

Medication Refill Requests

  • Urgent: Ask to speak with clinical staff
  • Non-urgent: 72 hours to complete
  • Pick-up: At the Pharmacy
  • Note: Medication Refill Requests are completed in primary care (Pediatrics, Family Medicine, Internal Medicine)