You should always have enough medication to last until your next appointment, often with one or two refills to spare. The most common exception to this is when new medication is introduced, before its tolerability and efficacy have been established, or at the outset of treatment, when titration of the dosage is anticipated. Once we are no longer making changes to a particular medication, 3-5 refills will be offered (up to a six month supply). You will never be expected to return to clinic just to obtain a refill of a non-controlled* substance; all clinic visits are predicated upon reviewing your progress and overall well-being, and checking for symptoms. 90-day and mail-order prescription orders are also available, upon request.
*Refills of habit-forming medications are typically limited to just enough to last until the next appointment. Under no circumstances will lost or stolen medications with street value be replaced, or refilled early. It is the patient's (or parents') responsibility to safeguard all medications, including and especially those classified as controlled substances and which are known to have significant street (black market) value.
For the patient taking a Schedule II controlled substance (e.g. Ritalin or Adderall), which cannot legally be refilled and which requires a new, signed and dated prescription order with each trip to the pharmacy, the required return-to-clinic frequency is monthly for at least three visits, or until there are no further adjustments to dosage and I am satisfied that the patient is not experiencing significant residual symptoms, untoward side effects, or other difficulties attributable to the direct effects of the medication. Thereafter, individuals seeking refills of these medications who are otherwise doing well are seen at least once a quarter (i.e., every three months), with refills provided as they become necessary, upon request. Exceptions do occur, and at the discretion of the physician a patient may be required to return to clinic for refills on a monthly basis for a longer, or even indefinite, period of time, but in no case will return visits for patients taking highly controlled substances be scheduled at greater than quarterly intervals. The maximum amount of time allowable between appointments for all other active patients is six months, although the recommendation for most patients is to return for well-checks, or check-ups, at least four times a year.
Finally, there may be times that, for various and unforeseen reasons, a patient runs out of medication between appointments. Refills can easily be requested through your pharmacy, or by contacting me via the Patient Portal. As long as there is a future appointment scheduled, and there is no past-due or other outstanding account balance, or other problems or delinquencies with your patient account, I am happy to provide additional refills of any medication, enough to last until your scheduled return. However, if you missed your last appointment, or are otherwise overdue to return to clinic, and especially if there is no future appointment scheduled, or your account is past due and you have failed to make arrangements for payment, your request for a refill may be delayed or denied.
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