Download Notice to Physician:

Notice to Physician:
Notice to Physician:
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
Random drug testing is conducted on me.
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
Random drug testing is conducted on me.
Thank You
Notice to Physician:
Thank You
Notice to Physician:
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
Random drug testing is conducted on me.
Random drug testing is conducted on me.
Thank You
Notice to Physician:
Thank You
Notice to Physician:
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
Random drug testing is conducted on me.
Random drug testing is conducted on me.
Thank You
Notice to Physician:
Thank You
Notice to Physician:
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
This is to advise you that I have a substance abuse disorder and
working an abstinence-based recovery program. This means I
should not have a controlled substance prescribed to me. If this
should be unavoidable due to extreme circumstances, the use of
such medications should be very short-term, administered by a
second party, monitored closely and no refills given without a
new order. Please make every effort to use high dosage
Ibuprofen and like medications for pain control.
Random drug testing is conducted on me.
Random drug testing is conducted on me.
Thank You
Thank You
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form
for this purpose.
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court participants are
required to notify the Drug Court Coordinator or Probation
Officer whenever any medication is prescribed or over-thecounter drugs recommended. Please notify the Drug Court in
writing or via telephone if you have prescribed or recommended
any medications.
I am willing to sign a release of information form for this
purpose.
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611
Billings Adult Misdemeanor Drug Court
PO Box 1178 • Billings, MT 59102
Linda Miller, Coordinator: (406) 671-8611