Advanced Pain Institute Sample Contracts

ADVANCED PAIN INSTITUTE
Advanced Pain Institute • January 21st, 2008

The following is an agreement of issues related to treatment of painful disorders through the use of medications and/or controlled substances. Because the medications are potentially dangerous, the side effects and risks are discussed with you at the beginning treatment and periodically thereafter. Opioid medication may cause drowsiness. Alcoholic beverages should be avoided and care should be used when driving/operating dangerous machinery. This facilities goal is to improve their patient’s quality of life and the ability to function and/or work. We ask our patients to carefully read, agree and follow the conditions outlined below for the duration of their care at this facility. Non-compliance with any one of these conditions may result in discharge from the practice.

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