Northern Virginia Pediatric Associates, P.C.
107 North Virginia Ave, Falls Church, VA 22046
24 Hour Phone #: (703) 532-4446 | Fax #: (703) 532-8426

By Appointment Only
Monday - Friday: 8:00 am - 7:00 pm
Saturday: 8:00 am - 1:00 pm
Sunday & Holidays: 9:00 am - 12 pm

Copyright © 2019 Northern Virginia Pediatric Associates, P.C. All Rights Reserved.

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Prescription Refill and Order Form

Patients needing ADHD medications must be seen every month until the medication and dose have been established. After that, we can prescribe medications for up to 90 days at a time. Patients should be seen at least every 3 months for the first year of treatment and at least every 6 months each year after that. Patients also need to be seen if there is a change of dose or a change of medication.

For schedule II prescriptions please fill out the form completely and accurately. Five working days may be needed for prescriptions to be completed. The prescription cannot be called to your pharmacist. Outside a visit, a fee of $15.00 will be due.

Please, use one form for each prescription.