Common Contracts

2 similar Controlled Substance Agreement contracts

Controlled Substance Agreement / Understanding
Controlled Substance Agreement • November 8th, 2019

We are committed to doing all we can to treat your chronic pain condition. In some cases, controlled substances are used as a therapeutic option in the management of chronic pain and related anxiety and depression, which is strictly regulated by both state and federal agencies. This agreement is a tool to protect both you and the physician by establishing guidelines, within the laws, for proper controlled substance use. The words “we” and “our” refer to the facility and the words “I”, “you”, “your”, “me”, or “my” refer to you, the patient.

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Controlled Substance Agreement / Understanding
Controlled Substance Agreement • June 9th, 2014

We are committed to doing all we can to treat your chronic pain condition. In some cases, controlled substances are used as a therapeutic option in the management of chronic pain and related anxiety and depression, which is strictly regulated by both state and federal agencies. This agreement is a tool to protect both you and the physician by establishing guidelines, within the laws, for proper controlled substance use. The words “we” and “our” refer to the facility and the words “I”, “you”, “your”, “me”, or “my” refer to you, the patient.

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