Common Contracts
1 similar Medication Agreement contracts
Patient/Provider Controlled Medication AgreementMedication Agreement • January 15th, 2022
The purpose of this agreement is to be certain that long-term controlled substances are prescribed in the safest, most effective manner in compliance with current law. Utilization of controlled substances over a long period of time may be medically useful, but may carry the risk of dependency, addiction, and loss of effectiveness. You must understand and agree to the following terms in order for us to enter with into a prescribing relationship. I understand that breaking the terms of this agreement will mean my doctor will no longer prescribe controlled substances for my condition. I understand that violating the terms of this agreement could result in discharge from the practice. Please initial next to each number.
