CONTROLLED SUBSTANCE PRESCRIPTION AGREEMENTControlled Substance Prescription Agreement • December 17th, 2020
Controlled substances are widely prescribed to treat ADD, ADHD, pain, anxiety, and insomnia. The success of treatment depends on mutual trust and honesty between the patient and the provider. Comprehensive Primary Care and Associates
CONTROLLED SUBSTANCE PRESCRIPTION AGREEMENTControlled Substance Prescription Agreement • January 11th, 2018
Depending on your specific care needs, your provider may prescribe you something that is deemed a controlled substance. To adequately care for you, the patient, please review the following agreement and sign. Failure to do so will prohibit you from receiving the medication you may need.
Controlled Substance Prescription AgreementControlled Substance Prescription Agreement • January 13th, 2016
Many patients will require the use of medications to help manage their pain to an acceptable level. These medications have risks and side effects. In addition to what is mentioned below your doctor will discuss these with you. You will need to understand and comply with what is outlined in this agreement in order for medications to be continues. It is unreasonable to expect complete relief of symptoms with medications. Our Goals is to provide medications that will help to make the pain Tolerable. If we take over the prescribing of your pain medications, you will be required to complete the medication
Optimal Health Associates CONTROLLED SUBSTANCE PRESCRIPTION AGREEMENTControlled Substance Prescription Agreement • June 2nd, 2020
The purpose of this agreement is to prevent misunderstandings about certain medicines the patient will be taking for pain management and/or anxiety management. This is to help both the patient and their provider comply with the law regarding controlled medications. Please read this contract thoroughly, as it is a condition of your continued treatment. Your signature will be required.
This is a contract because you or your child has been prescribed a controlled substance.Controlled Substance Prescription Agreement • March 25th, 2024
To meet strict state and federal guidelines and for our medical licenses, we are obliged to have agreements with our patients that are prescribed controlled substances.
