Monthly Periodic Review

[vc_row 0=””][vc_column][vc_column_text 0=””]IMPORTANT: PLEASE FILL OUT THIS DOCUMENT IF YOU ARE AN EXISTING PATIENT AND WERE DIRECTED TO FILL THIS DOCUMENT  OUT  BY YOUR PROVIDER

Once a month, we are going to reach out to you for a brief few minutes of your time. We are simply going to ask that you watch a very brief video from your Provider and answer a few questions.

Most importantly, we view this as an opportunity for you to take a moment and reflect upon three questions. Please fill this form to the best of your knowledge. Fields marked with an* are required:

 

Step 1:  Let’s begin by watching a short video from your Provider, the individual who is prescribing your Suboxone. Watch the Video below by clicking or tapping here(Coming Soon)

Step 2 :Now, we want to ask you three important questions: Click here to answer your monthly periodic review questions[/vc_column_text][/vc_column][/vc_row]

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