Rx Pain Medications: Prescription Pain Medication Agreement

Source: Substance Abuse and Mental Health Services Administration (SAMHSA)

One strategy for improving safe opioid prescribing is to have the patient and the health care provider enter into a prescription pain medication agreement. This sample agreement from SAMHSA can be used as is or adapted as needed.

Funding Source: Substance Abuse and Mental Health Services Administration (SAMHSA)

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Rx Pain Medications: Prescription Pain Medication Agreement

A sample prescription pain medication agreement for patients and their health care providers