Treatment bAgreementb - Alan J Zend DO PLLC 2025

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The document is a Buprenorphine Treatment Agreement from ALAN J ZEND DO PLLC, outlining the responsibilities and commitments of a patient seeking treatment for opioid addiction. It includes stipulations regarding appointment attendance, conduct, payment, medication handling, and participation in additional treatment programs. The agreement emphasizes the importance of adhering to prescribed guidelines and warns against the dangers of mixing medications.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the 'Patient Name' field, clearly indicating your identity for the treatment agreement.
In the section regarding your addiction, specify the drug(s) you are seeking treatment for. This is crucial for your physician's understanding of your needs.
Review each agreement point carefully. Acknowledge and check off each item as you agree to its terms, ensuring you understand your responsibilities regarding appointments, conduct, and medication management.
Sign and date the form at the bottom where indicated. Ensure a witness also signs and dates the document to validate the agreement.

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