Payers & Providers
Patients & Caregivers

Arizona Sample Pain Treatment Patient Agreement Forms

Source: Arizona Rethink RX Abuse

This resource provides two sample patient agreement forms for patients beginning or continuing long term treatment with opioid analgesics or other controlled substances. The agreement forms include information about how to obtain refills, the conditions of medication use, the

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Policymakers & Community Leaders
Patients & Caregivers

Arizona Department of Health Services – Standing Orders for Naloxone

Source: Arizona Rethink Rx Abuse & Arizona Department of Health

This resource is a copy of Arizona’s standing order signed by the Director of Health Services allowing pharmacists to dispense naloxone to anyone who requests it. Naloxone is used to reverse opioid overdoses. Part of the Arizona ReThink RX Abuse initiative which helps communities educate

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Patients & Caregivers

Opioid Safety and Naloxone Use for Patients and Caregivers, Spanish

Source: Arizona Rethink Rx Abuse & Arizona Department of Health

A Spanish language brochure for patients and caregivers with information about how to identify an opioid overdose and how to administer naloxone to reverse an opioid overdose either through injection, nasal spray, or auto-injector. Part of the Arizona ReThink RX Abuse initiative

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Patients & Caregivers

Opioid Safety and Naloxone Use for Patients and Caregivers

Source: Arizona Rethink Rx Abuse & Arizona Department of Health

This brochure serves as resource for patients and caregivers with information about how to identify an opioid overdose and how to administer naloxone to reverse an opioid overdose either through injection, nasal spray, or auto-injector. Part of the Arizona ReThink RX Abuse initiative

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Payers & Providers
Patients & Caregivers

Arizona Opioid Therapy for Chronic Pain – Sample Informed Consent

Source: Arizona Rethink RX Abuse

This resource provides a sample of an informed consent form for patients beginning or continuing long-term opioid therapy. It includes information about potential side effects, risks, conditions, and purpose of their treatment. Part of the Arizona ReThink RX Abuse initiative, which

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Payers & Providers
Patients & Caregivers

Having a Healthy Baby Begins Today: Pregnancy and Common Drugs or Medications, Spanish

Source: Arizona Rethink Rx Abuse & Arizona Department of Health

This Spanish language 2 page patient information guide provides information about the risks of taking common drugs or medications including opioids during pregnancy. Part of the Arizona ReThink RX Abuse initiative which helps communities educate their citizens about prescription drug safety.

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Payers & Providers
Patients & Caregivers

Having a Healthy Baby Begins Today: Pregnancy and Common Drugs or Medications

Source: Arizona Rethink Rx Abuse & Arizona Department of Health

This 2 page patient information guide provides information about the risks of taking common drugs or medications including opioids during pregnancy. Part of the Arizona ReThink RX Abuse initiative which helps communities educate their citizens about prescription drug safety.

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Patients & Caregivers

When a Loved One Passes – Handling Leftover Medication

Source: Arizona Rethink RX Abuse

This one page fact sheet explains why and how caregivers should safely dispose of their loved ones unused prescription medications after death. Part of the Arizona ReThink RX Abuse initiative which helps communities educate their citizens about prescription drug safety.

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Patients & Caregivers

Check Your Shelf!

Source: Arizona Rethink RX Abuse

A one page fact sheet that reminds people of the importance of safely disposing of their medications with guidance on how to find a prescription drug drop box. Part of the Arizona ReThink RX Abuse initiative which helps communities educate their citizens about prescription drug safety.

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Patients & Caregivers

Sharing Isn’t Caring

Source: Arizona Rethink RX Abuse

This one page infographic or poster conveys the simple message that patients should not share their medications with others. Part of the Arizona ReThink RX Abuse initiative which helps communities educate their citizens about prescription drug safety.

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