Common Contracts

1 similar Controlled Substance Agreement contracts

CONTROLLED SUBSTANCE AGREEMENT
Controlled Substance Agreement • August 22nd, 2017

This agreement relates to my use of controlled substances for chronic pain prescribed by a provider at Valley Pain Specialists, P.C. I have been informed and understand the policies regarding the use of controlled substances that are followed by the staff at Valley Pain Specialists. I understand that I will be provided controlled substances while actively participating in this program only if I adhere to the following conditions:

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