MEDICATION MANAGEMENT AGREEMENTMedication Management Agreement • January 12th, 2016
Contract Type FiledJanuary 12th, 2016This Agreement between Dr. Tomaszek and you is for the purpose of establishing clearly the conditions for receiving pain controlling medication prescriptions as provided by the doctor for you the “Patient”. For the purpose of this agreement, “Doctor” will refer to any physician of Doctor Tomaszek providing medications or treatment for your condition. The Doctor and Patient agree that adherence to this agreement is an essential factor in maintaining the trust and confidence necessary in a doctor/patient relationship.