Due to the extremely large volume of requests for medical records, hearing, vision, immunization records, school, sport, and camp forms, it has become necessary to implement a written policy for such requests. You may request any of the above listed forms to be completed for your child by calling our office at 404-351-6662, faxing us a written request at 404-351-6030, email us at firstname.lastname@example.org, or requesting at your office visit.
We have established an Annual Administrative Fee of $10.00 per child or $30.00 per family for completion of forms that will need to be paid prior to completion of forms request. This fee is not covered by your insurance company and in part covers the retrieval, administrative costs, and physicians’ review of your records and/or forms.
If you require a copy of your medical records, the first copy will be provided at no charge. Any additional copies will be charged according to the Georgia code.
Forms are completed on a ‘first in/first out’ basis. Please allow 5 business days for your request to be completed. We make every effort to complete these forms as quickly as possible. Due to the heavy volume of requests during back-to-school months, processing times may be longer. Please plan ahead!!
Parents MUST complete all information on the forms that they have knowledge of (i.e. demographics, health history, etc.), and MUST sign and date their portion of the form. Incomplete forms may delay the processing of your forms.
Parents will be required to provide self-addressed, stamped envelopes or pick up the forms at the office. Due to HIPPA Privacy regulations, we will no longer return completed forms via fax.
Prescriptions can be refilled on the same day if received by our office by 4pm. You may print a copy of our refill request form and fax it to our office. It is very important that you include the name of the medication, strength, dose the child takes, and the frequency with which it is taken, as well as the pharmacy name and phone number. For asthma medicine, please specify the delivery method (such as nebulizer, metered dose inhaler, etc.) Failure to provide this information may cause a delay in filling the prescription.
ADD medications cannot be phoned in to a pharmacy. You must present an original prescription to the pharmacist. We ask that you give us at least 24 hours’ notice for a refill on ADD medication in order to allow the staff to obtain the patient’s chart and the doctor to write the prescription. Prescriptions will be left in our nurse’s triage department for pick up or can be mailed if you have provided us with self-addressed stamped envelopes.
\ADD/ADHD medications, both brand and their generic equivalents, are classified as Schedule II Controlled Substances. These medications are federally controlled by the DEA and the FDA, which means a written prescription is required for each refill. Refills cannot be called or faxed to a pharmacy. Likewise, the pharmacy cannot call your doctor to get approval for your ADD/ADHD medication refills.
Please follow the following procedure when your child needs a refill of these medications:
Prescription Pick Up
Please note: Although we are aware mail can be lost by the U.S. Postal Service in some occasions, after two unsuccessful deliveries of your prescription, all future prescriptions must be picked up. No exceptions.
We appreciate your cooperation in following these guidelines. Please feel free to contact the office with any additional questions.