Rx Prescription Policy

Houston Medical Wellness Clinic’s prescription medication policy is designed for your safety and well-being during treatment. Questions about the policy should be directed to our staff or your provider.
  1. I understand that as a patient, I hold primary responsibility for my medications. HOUSTON MEDICAL WELLNESS CLINIC WILL NOT FILL OR REFILL / RE-WRITE MEDICATIONS OR SCRIPTS THAT ARE LOST, STOLEN OR DAMAGED IN ANY WAY. All medications are controlled substances and it is your responsibility to take care of your medication.
  2. If my medications are lost, stolen or misplaced, a replacement WILL NOT be given without a police report of the incident, specifically including your medication in the report.
  3. ALTERING PRESCRIPTIONS IS A FELONY. If you alter or forge any prescription you may be prosecuted. Use of illegal drugs may result in immediate dismissal from this clinic. We will not treat any patient engaged or implicated in such criminal activities.
  4. I will always take my medications as prescribed by my provider at Houston Medical Wellness Clinic.If I feel that the medication or amount of medication prescribed is inadequate, I will contact the clinic, which may require an office visit for further consultation.
  5. I will always keep track of the number of pills remaining, and schedule a follow-up visit as necessary.
  6. While I am receiving controlled-substance medications from Houston Medical Wellness Clinic, I agree not to receive from another physician the same medication, same class of medication, or any medications that may interact without notifying Houston Medical Wellness Clinic.
  7. I will not take any medications other than those prescribed to me by my doctors. I will not give my medication to others or “borrow” medications from others. I will let ALL of my treating doctors know ALL of the medications I am taking and why.
  8. For my safety and optimal treatment, I will immediately inform Houston Medical Wellness of any medications that I am actively taking. Not notifying my provider could increase my risk of adverse events, or even death from an overdose. Receiving controlled substances from another physician while receiving controlled-substance prescriptions from Houston Medical Wellness Clinic without notice, could result in my immediate discharge.

If you have any questions regarding our policies, please ask now before signing this consent form.

By signing below, I acknowledge that I have read these policies, understand these policies, and agree to abide by them fully.