Medication Refills & Paperwork

1) Please be advised that we do not refill medications over the phone, via fax, or regular email.  You must have a regularly scheduled visit in order to receive the proper medication refills.  If you have missed, cancelled, or no-showed for your appointment, we reserve the right to refuse your request.

 

2) If you lose your prescription, you must have a police report.  If this is a controlled substance, we will NOT refill those medications.  We reserve the right to refuse any refill.  

 

3) If you are on a controlled substance, you can only refill 30 days from the date that you last filled your medication.  We will not authorize any early refills.  If you run out of your controlled substance, we will not refill without an appointment.  

 

4) If you need medication adjustments, you must schedule an appointment. We will not adjust medications until you are seen and evaluated properly. You must request your refill 7 DAYS in advance NO EXCEPTIONS via the Patient Portal or through Updox medication refill email tranquilityMedrefills@myupdox.com

 

5) We understand that things come up and you may need to reschedule your appointment. Please contact us immediately as we offer several ways to facilitate your visit.  

6) Calls or Faxes from pharmacies will not be honored and is not an acceptable form of requesting a refill.

 

7) If you are having a severe medication reaction, please proceed to the nearest emergency room or call 911.  We are usually able to see you for an emergency visit the same day during our normal business hours to make medication adjustments.  

 

8) Please be advised starting October 1, 2020 anyone prescribed a controlled substance must be seen on a monthly basis to receive a refill. This is to ensure the necessity of the medication and to properly evaluate continued need for the controlled substance

 

9) If you any questions of concerns, please clink the link to the Patient Portal to message your provider directly or email us at tranquilityMedrefills@myupdox.com

Submitting Refill Requests

All medication refill requests should be sent using the medication refill form or Request a refill on Patientally.com

 

Include the following information in your refill request:

1) First and Last Name

2) Date of Birth

3) Name of Medication and dosage 

4) Last and upcoming appointment dates 

5) Email address and phone number 

One Medication Refill

$15.00

Two Medication Refills

$25.00

Three Medication Refills $30.00

7-Day Supply Medication Refill

$15.00

Medical Records Processing Fee (more than 20 pages) 

$50.00

FMLA/Disability Forms and Processing 

$50.00

Emotional Support Pet Letter

$25.00

VA Disability Paperwork

$75.00

Diagnosis and/or Treatment Letter

$25.00

Authorization Letter to Administer Medication by a School Nurse

$25.00

Educational 504 Accommodations Letter

$25.00

Medical Records Processing Fee

(20 pages or less) 

$25.00

201 Kingwood Medical Dr. Ste. A500, Kingwood, TX 77339

Phone: (832) 879-2107 Fax: (877) 495-4112

© 2016 by Tranquility Behavioral Health LLC. All  Rights Reserved.

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