Controlled Substances Treatment Agreement Sample Contracts

CONTROLLED SUBSTANCES (BENZODIAZEPINE) TREATMENT AGREEMENT
Controlled Substances Treatment Agreement • December 1st, 2020

The purpose of this agreement is to protect your access to controlled medication and to protect our ability to prescribe it for you.

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Controlled Substances Treatment Agreement
Controlled Substances Treatment Agreement • January 20th, 2016

Stimulant (narcotic) treatment for ADHD is used to decrease your ADHD symptoms and to improve what you’re able to do each day. Along with this treatment, other medical care may be prescribed to help improve your ability to do daily activities. This may include exercise, use of non-narcotic medication, psychological counseling or other therapies or treatment.

UW Medicine Controlled Substances Treatment Agreement
Controlled Substances Treatment Agreement • May 4th, 2012

Controlled substances can be dangerous. If they are not used carefully, you can become addicted to them or overdose on them. An overdose can cause death. Because of these dangers, it is important for you to understand the rules for using these medicines. This document describes our policy for prescribing these medicines and what your role is to keep yourself safe and get the best results if you use controlled substances.

TREATMENT AGREEMENT
Controlled Substances Treatment Agreement • January 13th, 2017

 Patients shall be seen by the physician at appropriate intervals, not to exceed 12 weeks to monitor the patient and evaluate progress.

Controlled Substances Treatment Agreement
Controlled Substances Treatment Agreement • July 24th, 2014

This agreement refers to medicines belonging to any of the following categories: Opiates, Opiate like (e.g. Tramadol), Benzodiazepines, Hypnotics and Stimulants

Controlled Substances Treatment Agreement
Controlled Substances Treatment Agreement • June 5th, 2019

Stimulant (narcotic) treatment for ADHD is used to decrease ADHD symptoms and to improve focus and functioning on a daily basis. Along with this treatment, other self-care may be prescribed to help improve your ability to participate in daily activities. These may include: exercise; mental health or other therapies; use of non-narcotic medication or other treatment options.

CONTROLLED SUBSTANCES TREATMENT AGREEMENT
Controlled Substances Treatment Agreement • December 22nd, 2020
TREATMENT AGREEMENT
Controlled Substances Treatment Agreement • January 13th, 2017

 The physician should provide reasons for which drug therapy may be discontinued, such as violation of the treatment agreement.

CONTROLLED SUBSTANCES TREATMENT AGREEMENT
Controlled Substances Treatment Agreement • June 23rd, 2020
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