If you need urgent help please call our office at (706)-232-1300.

Online refill requests will be processed within 72 hours Monday through Friday. Online prescription refills are not done on weekends and holidays. For those prescription requests received on Friday and weekend days, your prescription will be handled on the next business day. If you do not hear from us within that timeframe or should have any questions regarding your prescription refill or this online form, please contact us by phone at (706)-232-1300.

Dr Miniyar’s Pediatrics will not be held accountable should your electronic message not be transmitted due to technical problems related to this site or the hosting server. Please be aware that regular medical supervision is required to refill some prescriptions and you may be asked to make an appointment for your child to be evaluated before a refill request can be fulfilled.

For controlled substances such as ADHD medications, your child must have been seen in our office for a medical evaluation within the past three months AND your child must be up to date on his/her physical exam. Please remember you pick up a paper prescription from our office for controlled substances. All personal identifying information provided by you will be treated as confidential and your message will not be shared with any third parties. If you do not accept the terms of this site disclaimer, you will not be able to process your prescription request online.

Patient's Name:

First:

Last:

Name of the person requesting medication:

First:

Last:

Relationship with the patient:

Your working phone number:

Office Location Where You Will Pick Up The Prescription?:

Medications:

Name 1:

Dose 1:

Name 2:

Dose 2:

Name 3:

Dose 3:

Is your child up to date on yearly physical exam? YesNo

Is your child up to date on ADHD visit? YesNo

Note: If you do not get confirmation of submission. Please call our office to request the refill.

I accept the terms of the site disclaimer.