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1000 1661 Portage Avenue Winnipeg, MB R3J 3T7 Tel: (204) 7744344 Fax: (204) 7740750 Toll Free (MB only) 18777744344 www.cpsm.mb.caMANITOBA OPIOID AGONIST THERAPY RECOMMENDED PRACTICE MANUAL 2.3 Recommendations
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How to fill out manitoba opioid agonist formrapy

01
Check eligibility requirements for the Manitoba Opioid Agonist Therapy Program.
02
Fill out the personal information section on the form, including your name, date of birth, address, and contact information.
03
Provide information about your opioid use history, including the substances used, frequency of use, and any previous treatment programs.
04
List any medical conditions or allergies that may impact your treatment with opioid agonist therapy.
05
Have a healthcare provider complete the prescriber information section, including their contact information and relevant medical qualifications.
06
Submit the completed form to the Manitoba Opioid Agonist Therapy Program for review and approval.

Who needs manitoba opioid agonist formrapy?

01
Individuals who are struggling with opioid use disorder and are seeking treatment with opioid agonist therapy.
02
Patients who have been recommended by their healthcare provider to enroll in the Manitoba Opioid Agonist Therapy Program.
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Manitoba opioid agonist formrapy is a program in Manitoba that focuses on the use of opioid agonist therapy to treat opioid use disorder.
Healthcare providers who prescribe opioid agonist therapy in Manitoba are required to file the Manitoba opioid agonist formrapy.
The Manitoba opioid agonist formrapy can be filled out online through the designated platform provided by the provincial health authorities.
The purpose of the Manitoba opioid agonist formrapy is to track and monitor the use of opioid agonist therapy in the province to ensure safe and effective treatment for individuals with opioid use disorder.
The information reported on the Manitoba opioid agonist formrapy includes patient details, dosage prescribed, duration of treatment, and any relevant medical history.
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