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Available Forms

0. INSTRUCTIONS--MUST READ

NEW PATIENTS: There are forms you need to fill out before your first visit. Please see the instructions below as we treat patients with different medical needs.

FOR PAIN TREATMENT: please fill out forms 1-5 and the NARCOTIC PRESCRIBING Do NOT fill out the Suboxone or Marijuana Forms. We will call in one business day

For MEDICAL MARIJUANA certification: fill out forms 1-6.

FOR OPIOID DETOX OR ONGOING OPIOID USE DISORDER TREATMENT: please fill out forms 1-4 then the NON-DISCLOSURE AGREEMENT, then the 3 forms for Suboxone. DO NOT FILL OUT THE NARCOTIC DISPENSING AGREEMENT. If you wish, you can fill out the Pain Assessment Form if you also have a history of pain that is relevant to your opioid problem.

**WARNING: YOU MUST CLICK "SUBMIT FORM" AND SEE A MESSAGE IN GREEN STATING "SUCCESSFULLY SUBMITTED" BEFORE GOING TO THE NEXT FORM OR THE ENTIRE FORM WILL BE LOST**

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