Jump to Content
 

Available Forms

0. INSTRUCTIONS FOR NEW PATIENTS

NEW PATIENTS: There are forms you need to fill out before your first visit:

FOR PAIN TREATMENT: please fill out forms 1-5 and the NARCOTIC PRESCRIBING AGREEMENT. Do NOT fill out the Suboxone Forms. We will call in one business day (please note our business days are typically MWF).

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

FOR DETOX TREATMENT: If you need treatment for opioid misuse disorder, please fill out forms 1-4 then the 3 forms for Suboxone. If you wish, you can fill out the Pain Assessment Form if you also have pain.

If you need treatment for opioid misuse disorder and would like VIVITROL please fill out that form as well.

PLEASE NOTE: you MUST hit the "Submit Form" button at the bottom of the form AND see a message in green indicating that the form is successfully submitted or we did not receive the form.

* Required field