To prepare for your medication management visit, please make sure that you:
For new patients:
1. Print and fill out our Medication Reconciliation Form
2. Print and fill out our Review of Systems Form
3. Print and fill out our Patient Health Questionnaire
4. Print and fill out our Controlled Substances Treatment Agreement
5. Read our Medication Management FAQs
For returning patients:
1. Print and fill out our Review of Systems Form
Click here to learn how to connect for your virtual visit!
We are committed to being your partner for medication management services!
WE agree to:
- See you on a timely basis and no less than every 90 days
- Provide you with information regarding your diagnosis and medications
- Prescribe enough medication to get you to your next appointment
- Offer you an urgent visit for significant issues, either in person or via telepsych, within 48 hours if the provider is on-site.
- Use our best clinical judgment regarding medication and other treatment choices for you.
- This includes a very conservative approach to the use of addictive medications such as stimulants and benzodiazepines.
We require that YOU agree to:
- Schedule and attend all appointments as recommended.
- Failure to attend will result in discharge.
- Arrive early or on time.
- Take medications as prescribed. Early refills will not be provided.
- Recognize that refills are ONLY provided during regular office visits.
- If a phone refill is provided in an extreme case to provide medications until your next appointment, it may take up to 72 business hours and a $10 service fee will apply.
- Acknowledge that we do not process pharmacy refill requests.
- Attend an urgent in-person or telepsych visit should I experience significant medication issues.
- Such concerns cannot be adequately addressed via telephone.
- Medication changes are only made by providers during an office or telepsych visit.
- Safeguard all prescriptions and fill them in a timely manner.
- Lost, stolen, and/or expired prescriptions will incur a $10 service fee and may require additional documentation.
Thank you for GROWING with us!