Patient Reorder Form

As a patient of the premier men’s clinic in the Indianapolis, Indiana area, we want to make sure you have what you need. That’s why we made reordering your meds as easy and simply as possible. Just fill out the reorder form below, and we will reach out shortly to confirm your order.

NOTE: Allow AT LEAST 48 hours for your refill order to be processed. All orders will be available after 3:00 pm EST.

Reorder Form

Name*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Phone*
Email*
Sildenafil - 150mg
- Troche
- Rapid Desolving Tablet (RDT)
Quantity
Vardenefil - 75mg
- Troche
- Rapid Desolving Tablet (RDT)
Quantity
Tadalafil - 6.25mg / 75mg
- 6.25mg Troche
- 6.25mg RDT
- 75mg Troche
- 75mg RDT
Quantity
Trimix - Injectable Medication
- Trimix
Quantity

Name*
First Last
Phone*
Email*
What Can We Help With?*

Testimonials

Real Patients, Real Results

The entire staff was very knowledgeable and helpful and friendly. the treatment is very effective. its expensive, but well worth the money if you can manage. they will help you get your confidence back!
thank you!

Gene C.

I found the Indianapolis Men’s Clinic to be extremely professional!! Their initial exam was thorough and comprehensive! Your current health is taken into consideration when advising a client on the many options available! My experience has been positively successful!!! I do recommend a visit to IMC if you’re having symptoms of ED!

Paul R.

The men at the indianapolis mens clinic are professional, curteous and clearly strive to create the most accomodating atmosphere for a very touchy subject. Phil went above and beyond to find a solution for my problem and I can’t thank him enough.

David W.

Make An Appointment

Let Our Experts Help You Today!

11590 North Meridian Street, Ste. 405 Carmel, IN 46032 317.999.9000 Info@IndyMensClinic.com

Name*
First Last
Phone*
Email*
What are You Looking For?*
When Would You Like to Visit?*
Date Format: MM slash DD slash YYYY