The reason for this agreement is for you to understand the risks of narcotic medications for pain control and to understand our office medication policy in compliance with the United States Drug Enforcement Administration (DEA). The following policy will be strictly enforced. Your signature at the bottom of this page indicates that you understand and will abide by this policy. We take prescribing controlled substances very seriously. Controlled substances can become addicting and may have serious side effects.

 

We prescribe narcotic medications to help reduce pain to a tolerable level following surgery to help you be able to perform activities of daily living. Your pain may not be completely alleviated, however the goal is to make the pain tolerable. Opioid therapy may cause impairment in ability to perform tasks including but not limited to driving, operating machinery, or making decisions. We advise not to drive or operate machinery while taking narcotic medications.

Please thoroughly read the following agreement and sign if you agree to these terms. Please note, we will be unable to complete your request for narcotic medications unless the agreement is signed. Our goal is to provide optimal patient care. Your thorough understanding of our policy will help us continue to do this. Thank you for your cooperation.

Narcotic Agreement and Prescription Refill Policy

Contact Us: 1-302-366-7671
Fax: 1-302-292-8119

Delaware

Neurosurgical Group, P.A.

Delaware Neurosurgical Group, P.A.         774 Christiana Rd. Ste 202 Newark, DE 19713

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