Common Contracts
1 similar Informed Consent Agreement for Treatment With Controlled Medication contracts
Informed Consent Agreement for Treatment with Controlled MedicationInformed Consent Agreement for Treatment With Controlled Medication • December 4th, 2015
The purpose of this agreement is to provide information about the medications I will be taking for pain management and to assure that I and my physician comply with all state and federal regulations concerning the prescribing of controlled substances. The physician's goal is for me to have the best quality of life possible give the reality of my clinical condition. The success of the treatment depends on mutual trust and honesty in the physician/patient relationship and full agreement and understanding of the risks and benefits of using controlled substances to treat pain. I understand that there are alternative treatments which may include but may not be limited to: Nonnarcotic medication, Physical therapy, Injections, Surgery, Pain management referral, Acupuncture.
