Additional Services at Salem Road (Burlington Township)

Medication refill requests

  • Call 609-877-1500 and follow the prompts, or log on to MyCHOP to request medication refills.
  • Medication refill requests take up to three business days to complete.
  • A nurse may call you if an appointment is required to complete the request.

Specialist referrals

  • Call 609-877-1500 and follow the prompts, or log on to MyCHOP to request a specialist insurance referral.
  • Referral requests take up to five business days to complete.
  • If your primary care provider did not refer you to the specialist, a managed care coordinator may contact you for additional information. This may delay the referral.

Form completion

Download forms here.

During the visit:

  • Please bring all forms needed to scheduled visits.
  • Please complete all personal information in advance.

Outside the visit:

  • All form requests take 5 business days to complete. Please allow this time for processing.
  • A $10 fee will be applied for forms not completed during a visit.

Medical records requests

  • Log on to MyCHOP first to check for the information you need.
  • You can request a copy of your child’s medical records at any time by completing a HIPAA release form in the office.
  • Please note that requests for the full medical record may take 14 business days to process.