Resource Center: Initial patient contact
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Description:
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.
Source:
California Society of Addiction Medicine (CSAM) 0
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Tags:
- General information - buprenorphine
- Getting a waiver/setting up your practice
- Initial patient contact
- Screening and diagnosis
- Rules, regulations and recordkeeping
- Physician and staff training
- Addiction
- Assessment
- Confidentiality
- Consent
- Contract
- COWS
- Recordkeeping
- Screening
- Training
- Waiver
- Misc. informational materials
- Becoming waivered
- Just became waivered
- Need to refer
- Setting up a practice
Patient Handout: Confidentiality and Consent
Description:
This is a patient handout to inform patients about their rights when undergoing office-based buprenorphine treatment. Patient Rights: Confidentiality and Consent
As a patient getting treatment for a substance use disorder, your personal and medical
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Consent to Release Confidential Information
Description:
Consent to Release Confidential Information Consent to Release Confidential Information
I ___________________________________ hereby authorize and request,
Name: ______________________________________
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- Login or register to post comments
- Read more
- 1 attachment
Sample Consent Form
Description:
This is a sample of a consent form that can be used when initiating buprenorphine treatment for a new patient. BUPRENORPHINE MAINTENANCE TREATMENT
Sample #1 --Patient information and consent to treatment with buprenorphine
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Description:
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.
Source:
Colleen LaBelle, RN/Boston Medical Center 4.333335
Your rating: None Average: 4.3 (3 votes)
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Description:
This document provides a form for recording important information about prospective patients, including drug use history, treatment history, criminal history, health information, and more.
Source:
Colleen LaBelle, RN/Boston Medical Center 5
Your rating: None Average: 5 (2 votes)
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Description:
This flow chart for buprenorphine treatment displays the steps to patient recovery, from initial patient contact or referral, through intake process, induction, day #2, stabilization, maintenance, and tapering.
Source:
Colleen LaBelle, RN/Boston Medical Center 4.07143
Your rating: None Average: 4.1 (14 votes)
Tags:
- Initial patient contact
- Screening and diagnosis
- Induction and dosing
- Stabilization and maintenance
- Dosing
- Induction
- Intake
- Maintenance
- Screening
- Suboxone
- Tapering
- Induction/first treatment
- Medical assessment/first visit
- Misc. informational materials
- Treatment Algorithm
- Just became waivered
- Setting up a practice
Description:
This checklist provides a list of the forms that must be signed, the information that should be recorded for each patient (including current medications and allergies), and tests and labs that should be drawn during the intake assessment.
Source:
Colleen LaBelle, RN/Boston Medical Center 4.333335
Your rating: None Average: 4.3 (3 votes)
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Description:
This patient questionnaire from the California Society of Addiction Medicine (CSAM) is useful when beginning a new patient on buprenorphine maintenance treatment.
Source:
California Society of Addiction Medicine (CSAM) 4.333335
Your rating: None Average: 4.3 (3 votes)
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Description:
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.
Source:
California Society of Addiction Medicine (CSAM) 0
Your rating: None
Tags:
- Home
- Training/CME
- Resources
- How-To Guides
- All How-To Guides
- Get Started Prescribing Buprenorphine
- Assess and Treat Patients with Comorbid Health Issues
- Conduct Buprenorphine Induction
- Establish and Manage a Buprenorphine Practice
- Manage Challenging Patients
- Comply with Rules, Regulations, and Recordkeeping
- Understand Insurance and Billing Issues
- Screen for Substance Abuse
- Refer Patients to an Addiction Specialist
- Review: What is Buprenorphine?
- Your Bup Site!
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Patient Handouts
Physician stage in practice
- Just became waivered (13)
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- Becoming waivered (1)
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