SCHEDULED APPOINTMENTS
Your time reserved with the provider is valuable. You must attend all of your appointments to continue your treatment at the Center. We understand that there are times that moving an appointment is unavoidable, but when it becomes a pattern this is concerning and a breach of your controlled substance agreement. If you do not show for your appointment, you may not be eligible for a refill of your medications or tapering of your medications may begin. Please call the clinic in advance if you need to reschedule. If we reschedule your appointment due to illness, inclement weather, or other issues, we will provide a bridge prescription until your next appointment. If you do not attend your appointment or do not call at least 24 hours in advance to cancel, you may be subject to a $75 fee. Payment of the $75 fee will be required before you can reschedule your appointment.
DO NOT BE LATE FOR YOUR APPOINTMENTS
Please arrive 15 minutes before your appointment. This ensures that you will be seen by your provider. If you arrive late, your appointment may be rescheduled. Notifying us that you are going to arrive late, allows us to consider options for you to still be seen. If feasible, we may allow you to wait and be worked in the schedule if another patient is detained. If you are due a new prescription, a partial prescription may be provided at the doctor’s discretion.
YOUR FINANCIAL RESPONSIBILTY
You are required to pay your copay and any outstanding balance at the time of your visit. Your payment will be collected when you register at the front desk. If you are not prepared to pay your copay, call at least 48 hours in advance to discuss with our financial coordinator.
NOT EVERYONE IS APPROPRIATE FOR NARCOTIC USE
The provider will determine if the use of controlled substances like narcotics are medically indicated. If they are not indicated, you will be offered other options for pain control. If you are a candidate for narcotic medications for pain control, continuation will depend on
Compliance with goals and documentation of progress
Adherence to the Controlled Substance Agreement
Urine drug screens are consistent with prescribed medications and absence of any illicit substance
ONE PHYSICIAN
The providers in our clinic work as a team. If your provider is out of the office at the time you need a prescription refill, another provider has been assigned to refill prescriptions. If that provider is not familiar with you, they may only provide a partial prescription to maintain your medication until your provider is available.
INFORMING THE OFFICE OF NEW OR CHANGE IN MEDICATIONS
Notify us of any change in medications as there could be interaction between drugs that we are prescribing. If you receive a prescription for a controlled substance from your primary care physician, emergency room doctor, dentist, or specialist, notify our clinic immediately. We will determine if you should fill this prescription or not. Be sure to tell all other providers that you have a controlled substance agreement. Remember that often cough medications contain a controlled substance. Controlled substances are drugs that have some potential for abuse or dependence such as, morphine, oxycodone (Percocet), oxymorphone (Opana), methadone, fentanyl, codeine, hydrocodone (Lortab), hydromorphone (Dilaudid), tapentadol (Nucynta), barbituates, pregabalin (Lyrica), tramadol (Ultram), buprenorphine (Butrans), and benzodiazepines (diazepam {Valium}, alprazolam {Xanax}, lorazepam {Ativan}, clonazepam {Klonopin}, etc.).
When you are taking a most medications (especially narcotics), it is important to avoid any use of alcohol or use recreational drugs. Do not drive or operate machinery until you know how the medication affects you. Always error on the side of safety.
INFORMING THE OFFICE OF ADVERSE EFFECTS
If you have an unwanted side effect or complication from the medications you are prescribed, contact the clinic immediately. Some side effects are time limited and will go away as your body gets use to the medication. If you are hospitalized for any reason related to your medications or experience an overdose, our clinic must be notified.
TAKE YOUR MEDICATIONS ONLY AS PRESCRIBED
Only take your medications as prescribed. It is best to take pain medications consistently. Do not take an extra pill or you will run out. Notify the clinic if your pain is not adequately controlled.
PROMISE NOT TO SHARE, SELL, OR ALLOW OTHERS ACCESS TO YOUR MEDICATIONS
Never share, sell, or allow other access to your medications. Sharing and selling medications is against the law. We may have an obligation to alert the drug enforcement officers if diversion of the medication is evident. You should always keep your medications locked up to safeguard your medications.
NEVER STOP YOUR MEDICATIONS ABRUPTLY
Stopping your medications suddenly can cause you to develop withdrawal symptoms. Some of the symptoms include heart racing, sweating, restlessness, shakiness, runny nose, tearing, stomach cramps, nausea, vomiting, diarrhea, yawning, anxiety, irritability, goosebumps, and joint/muscle aches. If you choose to get off the medications, we will assist you with tapering.
COMPLY WITH RECOMMENDED TAPERING
There are times that tapering the medications is appropriate or required. Escalating pain may indicate opioid-induced hyperalgesia, which means that your pain is caused or actually worsened by the medications. Opioids can also cause increased anxiety. If we determine that you the medications are causing problems, we will assist you in an appropriate taper.
SUBMIT TO URINE DRUG SCREENS ON REQUEST
Urine drug screens are performed at the first visit, at subsequent visits, and randomly as the provider determines is necessary. You must comply with all requests without delay. Random drug screens can be requested at any time and you must comply with testing within 24 hours of the request. You may get a separate bill for the drug screen. If you have difficulty with the cost, contact the company and they will work with you.
BRING ALL MEDS IN THEIR ORIGINAL CONTAINERS TO APPOINTMENTS
Bring all of your medications we prescribe to the clinic in their original containers. If you have any new prescriptions from any prescription since your last visit, bring the meds in their original container.
LOST OR STOLEN PRESCRIPTIONS
If your pills or prescriptions are lost or stolen, you must have a police report and be seen in the clinic immediately. It is up to the provider to decide if a replacement prescription is indicated. You may be placed on shorter term prescription, which can require you to pick up prescriptions weekly at the clinic. It is your responsibility to keep your medications safe and unavailable to others.
NO EARLY REFILLS
There are no early refills. Do not open bottles over a sink. If you drop them or misplace them, a replacement prescription will not be provided. If you have taken more medication than prescribed without permission from your prescribing provider, you will have to be seen prior to your next prescription is written. You may be required to taper and discontinue the medications.
EARLY ISSUE PRESCRIPTIONS
In rare cases, you may be given a prescription in advance of the monthly refill date. This may occur when your provider knows in advance that they will be out of town when your refill is due or it may be as a courtesy for your convenience as an established, trustworthy patient. The prescription will instruct the pharmacist not to fill before the appropriate time frame.
LEGAL AUTHORITY QUERY
If legal authorities have questions concerning your controlled substances prescribed, we will cooperate with the authorities and provide requested records. This may occur if you obtain medications from several pharmacies and for other reasons.
PRESCRIPTION REFILLS
Please give us a 7-day notice for prescription refills. Call 434-200-4175. Option 3 will send you to the refill message line. Leave the following detailed information:
Full name (spell your last name)
Date of birth
Phone number to reach you for any questions
Name of your medication, strength of medication (number of mg), and how often you take it.
The nurses will check the refill messages frequently throughout the office hours Monday through Friday. You may leave a message any day of the week and at any time of the day on the refill message line only. The nurse retrieves the message, researches your prescription, and sends the request to the provider. Our providers are not in the clinic every day of the week, but once the provider completes the prescription, the nurse will call to let you know your prescription is available. The 7-day notice allows the nurse to contact you if there are any questions or if you need to be seen by the provider prior to the prescription refill. If you provide less than 7-day notice, we cannot guarantee that you will receive your refill before you run out of medication.
ONGOING TREATMENT
Understand that your medical treatment is initially a trial and prescriptions are continued when they provide measured benefits. Goals must be set and achieved to maintain use of medications. Often, pain inhibits your ability to move causing you to gain weight. Increased activity and measurable weight loss is an example of a goal and may be required to continue use of the medications.
BREACH OF CONTRACT
Continued treatment requires a level of trust between the provider and the patient. Following the rules establishes a foundation of trust. If you do not follow the rules, you are in breach of the contract. This means that medications will be tapered or discontinued. You may be dismissed from the practice or may be offered alternative treatments at the discretion of the provider.
