Get the free Part 822-5 Opioid Treatment Program Collateral Contact Note - oasas ny

Part 8225 Opioid Treatment Program Collateral Contact Note Patient Name Patient ID # Date of Service Duration of Service Name(s) of Collateral Contact(s) for this visit Relationship to Patient What

How to fill out part 822-5 opioid treatment

How to fill out part 822-5 opioid treatment:

1. Start by carefully reading the instructions provided on the form. Pay attention to any specific requirements, guidelines, or deadlines mentioned.
2. Enter your personal information accurately in the designated fields. This may include your full name, address, contact information, and relevant identification details.
3. Provide information about the opioid treatment facility in which you are currently receiving or planning to receive treatment. This may involve detailing the facility's name, address, and contact information.
4. Indicate the type of opioid treatment program you are involved in or seeking to participate in. This could include options such as outpatient treatment, residential treatment, maintenance therapy, or detoxification.
5. Describe your medical history and any relevant information related to your opioid treatment. This may involve disclosing any past or current medications, previous treatments, and any known allergies or medical conditions.
6. If applicable, provide details about your primary healthcare provider or prescribing physician. Include their name, contact information, and any other requested details regarding their involvement in your opioid treatment.
7. Sign and date the form in the designated areas, demonstrating your understanding and agreement to the information provided. Ensure that all necessary signatures are obtained, depending on the requirements outlined in the instructions.

Who needs part 822-5 opioid treatment?

1. Individuals who are currently undergoing opioid treatment at a certified facility may be required to fill out part 822-5. This includes individuals enrolled in outpatient or residential treatment programs, as well as those seeking maintenance therapy or detoxification services.
2. Patients who are planning to initiate opioid treatment may also need to complete part 822-5 as a part of the intake process. This helps in gathering essential information about the individual's medical history and treatment preferences, enabling healthcare providers to better tailor the treatment plan.
3. Healthcare professionals involved in the management and oversight of opioid treatment programs may utilize part 822-5 for documentation and regulatory purposes. This ensures compliance with the necessary guidelines and regulations set forth by governing bodies responsible for monitoring opioid treatment programs.

For pdfFiller’s FAQs

What is part 822-5 opioid treatment?

Part 822-5 opioid treatment refers to the regulation that oversees the treatment and reporting of opioid addiction.

Who is required to file part 822-5 opioid treatment?

Healthcare providers and facilities that offer opioid treatment programs are required to file part 822-5 opioid treatment.

How to fill out part 822-5 opioid treatment?

Part 822-5 opioid treatment must be filled out by providing accurate information about the opioid treatment program and reporting requirements.

What is the purpose of part 822-5 opioid treatment?

The purpose of part 822-5 opioid treatment is to regulate and monitor opioid treatment programs to ensure compliance and quality of care for patients.

What information must be reported on part 822-5 opioid treatment?

Part 822-5 opioid treatment requires reporting on patient demographics, treatment plans, progress notes, and outcomes.

Where do I find part 822-5 opioid treatment?

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