Common Contracts
1 similar Opioid Treatment Agreement contracts
OPIOID TREATMENT AGREEMENTOpioid Treatment Agreement • March 20th, 2015
Opioid (narcotic) treatment for chronic pain is used to reduce pain and improve what you are able to do each day. Along with opioid treatment, other medical care may be prescribed to help improve your ability to do daily activities. This may include exercise, use of non‐narcotic analgesics, physical therapy, psychological counseling or other therapies or treatment. Vocational counseling may be provided to assist in your return to work effort. I, , understand that compliance withthe following guidelines is important in continuing pain treatment with Dr. . 1. I understand that I have the following responsibilities:a. I will take medications only at the dose and frequency prescribed.b. I will not increase or change medications without the approval of this provider.c. I will actively participate in Return to Work (RTW) efforts and in any program designed to improve function (including social, physical, psychological and daily or work activities).d. I will not request opioids or any other p
