Consent

Description: 
This patient consent form (in Word®) explains buprenorphine treatment and warns about the adverse effects of mixing buprenorphine with other medications. The section at the bottom is for the patient and a witness to sign and date, indicating that the patient understands and wishes to receive treatment.
Source: 
California Society of Addiction Medicine (CSAM)
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Physician stage in practice: 
Resource Type: 
Description: 
The California Society of Addiction Medicine (CSAM) website provides information and materials for buprenorphine treatment providers, including screening tools and sample consent and patient agreement forms, and provides links to other helpful resources.
Source: 
California Society of Addiction Medicine (CSAM)
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Description: 
Analyzes the misconceptions that arise from the Health Insurance Portability and Accountability Act and discusses when health care providers should use their professional judgment in deciding whether a disclosure is necessary.
Source: 
Journal of the American Medical Association (JAMA) 2005 Apr 13;293(14):1766-71.
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Resource Type: 
Description: 
This series of tables provides state-by-state information about minors' rights regarding providing consent for substance abuse treatment.
Source: 
Guttmacher Institute
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Commonly Used Forms: 
Description: 
Patient contract that can be used to set expectations and guidelines before beginning buprenorphine treatment.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Commonly Used Forms: 
Description: 
Four-page document discussing treatment of pregnant patients with buprenorphine.
Source: 
Physician Clinical Support System (PCSS)
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Physician stage in practice: 
Description: 
Guidance on the legal rights of individuals with alcohol and drug problems to help patients understand how they are protected from discrimination.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Patient Handouts: 
Description: 
This booklet provides a general overview of the principles that characterize effective treatment for drug addiction, and can be used to introduce staff and patients to this topic.
Source: 
National Institute on Drug Abuse (NIDA)
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Physician stage in practice: 
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