Heritage Hills & Addiction Medicine
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Downloads

ADMINISTRATIVE

New Patient Form.pdf

CONSENT FORMS

Consent Induction day & next day instructions.pdf
Consent Lamictal Continuation.pdf
Lamictal Start Consent.pdf
Consent never accept narcsbenzo from other MD.pdf
Consent opioidsbenzo.pdf
Consent Psych meds.pdf
Consent random UAmed counts .pdf 

Consent suboxone pregnancy.pdf
Consent to disc c other providers.pdf 
Records Release.pdf
Suboxone Induction withdrawl meds.pdf
Suboxone regulations followup.pdf
Suboxone Cutting Template
Consent safety contract.pdf

OPIATE RELATED

Opiate withdrawl scale.pdf
Vivitrol Enrollment Form

MEDICAL LEAVE FORMS

FMLA form.pdf

MENTAL HEALTH

ADHD form for parents.pdf
ADHD form for teachers.pdf
Depression PHQ-9 Form
OCD Scale
Depression Scale CES-D

Clinical Forms

Cologuard Test Order Requisition Form.pdf

Pain Management Forms

Patient review for ongoing pain management
SOAP-R
Pain disability index

Recertified from 2017 – 2027.
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