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How to use or fill out consent naltrexone form with our platform
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Click ‘Get Form’ to open the consent naltrexone form in the editor.
Begin by entering your name and date of birth in the designated fields. This information is crucial for identifying your medical records.
Read through the section outlining the reasons for using naltrexone, including potential benefits and side effects. Ensure you understand this information thoroughly.
In the initial section, provide your initials to confirm that you acknowledge the need to be weaned off narcotics before starting naltrexone.
Sign and date the form at the bottom. This confirms your agreement to proceed with treatment and that all questions have been answered satisfactorily.
Start filling out your consent naltrexone form today for free on our platform!
Naltrexone is available as an intramuscular injection (Vivitrol) and as oral tablets.
How do you write a good consent form?
The consent form should describe if/when identifiable data will be destroyed and how such data will be protected and how it will be used or shared. Language - Consent forms should be written in the 2nd person (i.e., you are) and in a language that is clear, concise, and understandable to the subject population.
What is necessary before a patient can start naltrexone?
It is necessary to stop all drugs/medications that have any opiates/opioids in them 710 days before starting naltrexone to avoid getting sick. It is also important that you NOT have any opioids (such as: methadone, , , oxycodone, ultram, etc.)
Does naltrexone require prior authorization?
Extended-release injectable naltrexone often requires prior authorization from insurance and ordering through a specialty pharmacy; this process may take several days and requires thoughtful planning.
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Injectable Naltrexone Tools Resources Ford Research Group
Pharmacy Forms. The attached forms have been provided by Omro Pharmacy (Vivitrol Treatment Informed Consent Form) and Smith Pharmacy (Vivitrol Pre-Injection
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