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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 and NON-DISCLOSURE AGREEMENT. Do NOT fill out the Suboxone or Marijuana 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 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.

If you need treatment for opioid misuse disorder and would like VIVITROL please fill out the Vivitrol Consent but not the Suboxone forms

**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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