OPEN 5 DAYS A WEEK. WALK IN OR CALL Request Prescription Refill Online American Urgent Care & Infusion Centers helps you save time and money. Fill out the form below to submit your prescription refill request. Twitter First Name * Email Address * Last Name * Patient's Date of Birth Contact Cell Number Patient's 5 Digit Zip Code Last 4 Digits of SSN Which Clinic Is It Related To Select Clinic 6125 S Eastern Ave. 4161 S Eastern Ave. Maryland Pkwy Jeffery's Henderson Rainbow Blvd Not Applicable Message Subject Enter Your Message * Your enquiry has been sent successfully.