Common Contracts
2 similar Behavioral and Controlled Substance Agreement contracts
Behavioral and Controlled Substance AgreementBehavioral and Controlled Substance Agreement • January 18th, 2023
This agreement between you and your child’s provider at Pediatric Associates is made in order for you to understand your personal responsibilities while your child is taking one or more of the following prescriptions: benzodiazepine and/or antipsychotic, stimulant medication, sleep medication, anti-depressant medication, and/or anti-anxiety medication. Please read the agreement fully and ask any questions that you have prior to signing.
Behavioral and Controlled Substance AgreementBehavioral and Controlled Substance Agreement • February 25th, 2019
This agreement between you and your child’s provider at Pediatric Associates is made in order for you to understand your personal responsibilities while your child is taking one or more of the following prescriptions: benzodiazepine and/or antipsychotic, stimulant medication, sleep medication, anti-depressant medication, and/or anti-anxiety medication. Please read the agreement fully and ask any questions that you have prior to signing.
