Bupenorphine (Suboxone, Zubsolv) Refill Policy

If you are taking the medication Buprenorphine prescribed by Dr. Kushner you agree to the following:

1. REFILLS WILL NOT BE GIVEN OVER THE PHONE There will be NO EXCEPTIONS to this.
2. It is the responsibility of you the patient, to keep track of when you will need a refill and to call Dr. Kushner’s office in advance to schedule an appointment for a refill.
3. When you leave an appointment and a prescription for buprenorphine is given to you, Dr. Kushner is under the assumption that you are taking the medication as prescribed unless you call and let her know otherwise.
4. If you lose a prescription or it gets stolen, or you take too much or too little of your medication, it is up to you to schedule an appointment to see Dr. Kushner to get a new prescription. It WILL NOT be filled over the phone!
5. If you run out of your medication and go without it for 24 hours, you may start to feel withdrawal symptoms that may consist of muscle cramps, nausea, abdominal pain, runny nose, and/or sweating. This is usually NOT life threatening.
6. If you need or want medical attention and the office is not open you may go to an emergency room or call 911.
7. Remember that buprenorphine is not used by itself. It is part of a comprehensive treatment regimen that may include 12 step meetings, sponsorship, group therapy, individual therapy and other methods of support.

I understand and agree to follow this policy

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