Get Controlled Substance Agreement Form

The Controlled Substance Agreement Form is an essential document designed to establish a mutual understanding between the provider and the patient regarding the use of controlled substances. This guide will take you through the online process of completing this form with clarity and support.

Follow the steps to fill out the Controlled Substance Agreement Form online

1. Press the ‘Get Form’ button to access the Controlled Substance Agreement Form and open it in the editor.
2. Begin by filling in the medication name in the designated field, which is intended for the specific controlled substance prescribed.
3. Next, specify your medical condition in the provided space, accurately reflecting the reason for your treatment.
4. Carefully read and acknowledge the goals for using the medication, ensuring you understand what the treatment aims to achieve.
5. Review the section detailing provider responsibilities, which outlines the obligations of your healthcare provider.
6. Proceed to the patient responsibilities section, where you must commit to following the treatment plan and the rules regarding medication use.
7. Fill in your name in the patient name field and provide your signature to acknowledge your agreement to the terms stated in the document.
8. Enter the date on which you are signing the form.
9. Provide the provider’s name and signature, followed by entering the date of their signature.
10. Finally, ensure you save your changes, and download, print, or share the completed form as needed.

Complete your Controlled Substance Agreement Form online today for a clearer understanding of your treatment responsibilities.