TREATMENT CONTRACTTreatment Contract • October 29th, 2021 • Maryland
This Treatment Contract is between DC Psychology and Sleep Services, LLC, and the patient whose signature and printed name is at the end of this Treatment Contract.
PATIENT TREATMENT CONTRACTTreatment Contract • August 20th, 2020
As a participant in Pain Management treatment I understand that I may be prescribed medication(s), and that Pacific Coast Spine Institute and Pain Center has important policies regarding prescription treatment and general care. Treatment may not begin without this signed contract.
Treatment ContractTreatment Contract • August 28th, 2014
The purpose of this contract is to organize my care for bipolar disorder, with attention to both the prevention of mood episodes and the efficient treatment of these episodes should they occur. My first step in guiding my care is the selection of my support team. The team members should include people with whom I have regular contact, who can help me identify episodes should they occur and help me put into practice some of the tools discussed in earlier chapters of this workbook.
TREATMENT CONTRACTTreatment Contract • November 4th, 2020
This Treatment Contract is between DC Psychology and Sleep Services, LLC, and the patient whose signature and printed name is at the end of this Treatment Contract.
TREATMENT CONTRACT - GOOD DAY THERAPYTreatment Contract • June 10th, 2020
Deciding to access support is a positive step forward and we hope to help you achieve more good days. There is a huge amount of research supporting the positive impact of therapy, which gives you a great starting point. Added to this we really value having this opportunity to assist you in your journey to achieve whatever personal goals you set and will not shy away from the hard work this may require.
TREATMENT CONTRACT / CONSENT TO CARETreatment Contract • September 2nd, 2010
PATIENT SUBOXONE TREATMENT CONTRACTTreatment Contract • June 23rd, 2022
As a participant in buprenorphine treatment for opioid misuse and dependence, I freely and voluntarily agree to accept this treatment contract as follows:
PATIENT TREATMENT CONTRACTTreatment Contract • April 23rd, 2019
As a participant in medication treatment for opioid misuse and dependence, I freely and voluntarily agree to accept this treatment contract as follows:
TREATMENT CONTRACT - GOOD DAY THERAPYTreatment Contract • May 20th, 2019
Deciding to access support is a positive step forward and we hope to help you achieve more good days - we aim to help you develop a range of therapeutic tools that you can use for the rest of your life. There is a huge amount of research supporting the positive impact of therapy, which gives you a great starting point. Added to this we really value having this opportunity to assist you in your journey to achieve whatever personal goals you set and will not shy away from the hard work this may require.
TREATMENT CONTRACT FOR SUBOXONE (BUPRENORPHINE) THERAPY PROGRAM REQUIREMENTS AND PATIENT RESPONSIBILITIESTreatment Contract • March 22nd, 2017
Suboxone (also known as Buprenorphine/Naloxone) is used to help people treat addiction to narcotic drugs. These are the requirements and responsibilities you must follow in order for you to successfully participate in addiction treatment therapy which includes Suboxone. In order to receive Suboxone from Marquette General Health System, you must fully agree to this Treatment Contract and place your initials next to each item and sign this Treatment Contract.
