I understand that NO MEDICATION is kept on site including Suboxone, Subutex, or any other Narcotic.
I agree that group is a requirement of treatment and I must attend at least four groups within a 28 day period in order to receive my prescription. Any missed group sessions prior to my doctors’ appointment will result in me not being able to get medication until my next scheduled visit and once I meet all the treatment requirements to remain in compliance.
I agree that the medication I receive is my responsibility and that I will keep it in a safe and secure location. I agree that lost medication will not be replaced regardless of reason.
I agree to take my medication exactly as prescribed by the doctor and not to alter my medication schedule without first consulting the doctor.
It is a felony to be found trading or selling your prescription; prescription/medication counting maybe utilized during my treatment to ensure I am taking the medication exactly as prescribed. I agree not to sell, share or give away any of my medication to another person. I understand that such mishandling of my medication is a serious violation of this agreement and would result in discharge from treatment without recourse for appeal or reimbursement.
I agree not to obtain medications from any physicians, pharmacists, or other sources without informing my treatment physician. I understand that mixing Buprenorphine with other medications, especially benzodiazepines (such as: valium-(diazepam), Xanax-(alprazolam), Librium-(chlordiazepoxide), Ativan- (lorazepam), Klonopin, and/or any other drugs of abuse including alcohol can be dangerous. I also understand the number of deaths have been reported in persons mixing Buprenorphine with Benzodiazepines.
I understand that I may be discharged immediately if I test positive for any Benzodiazepine.