Resource Center: Contract

Discusses the importance of setting guidelines for patients in an office-based buprenorphine program and gives examples of the types of procedures and protocol that should be set and agreed upon prior to beginning treatment.

This consent form informs the patient of the limited amount of research and knowledge currently available regarding buprenorphine use during pregnancy, and acknowledges that risks related to such use may exist, but are not yet known.

This chapter of the TIP 45 discusses funding, resources, organization and patient contracts in substance abuse treatment.

Patient contract that can be used to set expectations and guidelines before beginning buprenorphine treatment.

This patient consent form (in Word®) explains buprenorphine treatment and warns about the adverse effects of mixing buprenorphine with other medications. The section at the bottom is for the patient and a witness to sign and date, indicating that the patient understands and wishes to receive treatment.

The California Society of Addiction Medicine (CSAM) website provides information and materials for buprenorphine treatment providers, including screening tools and sample consent and patient agreement forms, and provides links to other helpful resources.

Patient contract that can be used to set expectations and guidelines before beginning buprenorphine treatment.

This form serves as a sample consent for release of the patient's information (type of information to be specified by the patient and/or doctor).

Patient contract that can be used to set expectations and guidelines before beginning buprenorphine treatment.