MEDICATION AGREEMENT

Treatment with medications is only one part of an entire toolbox used to address medical and mental conditions. Other forms of treatment will be individually discussed with your doctors because everyone is an individual.

This agreement in no way is intended to accuse you the patient of any wrongdoing. Medications even “controlled” can be a great tool for overcoming pain, addressing dependence, and increasing the changes of escaping some addictions.

Prescriptions medications once picked up at your pharmacy are your responsibility

Some medications referred to as “controlled” include but are not limited to:

-Buprenorphine / buprenorphine-naloxone (suboxone)
-Alprazolam (xanax)
-Hydrocodone with acetaminophine - (lortab, norco, vicodin)
-Clonazepam (Klonopin)
-Zolpidem (Ambien)
-Amphetamine/dextroamphetamine (Adderall)

All medications should be taken as prescribed. Do NOT increase the amount of the medication you take; Do NOT increase how often you take your medication unless directed by your doctor / NP FIRST.

Prescriptions are written so that you will have enough medication to last until your next appointment. This is one of the many reasons why keeping your appointments is so important to your care. Our appointments are done by tele-med so that travel time to and from the appointment is eliminated.

If labs are ordered there is a reason, please have them done at a certified labs like CPL, Quest ect Some medications require blood levels to titrate other medications require regular monitoring of things like liver functions.

We understand on rare occasions life emergencies happen. If you must reschedule your appointment, please do so as soon as you can. We ask for 24-hour notice so that the appointment can be offered to someone else if necessary. Because of the preparation that goes into appointments the evening prior we are going to begin charging a no-show fee/last minute cancellation charge.

If you must have a refill of a controlled medications (the list above) to prevent you from running out due to a rescheduled appointment it is called “a bridge”.Bridge prescriptions come with a set of rules covered elsewhere.

We are in the office during regular office hours. Medication refills are not available in the evenings, wee hours of the morning, weekends or during holidays.

Your prescriptions are for YOU and only you. You agree not share, sell or ‘loan” your medication to someone else. If someoneyou know needs medications for pain or treatment,they need to see a doctor, (we are honored when patient’s refer othersto our practice)

Your medications are YOURS

Please avoid taking other people’smedications. If your medications are not controlling your symptoms, please let your MAPS provider know.

You are responsible for the safe storage of your medications. You MUST keep your medications secure as they could be fatal to small children and pets.