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Publication withdrawn This guidance was withdrawn in April 2024. For update information about the National Drug Treatment Monitoring System (ND TMS), see core data set documentation on the ND TMS

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How to fill out withdrawn national drug treatment

01

Request a copy of the withdrawn national drug treatment form

02

Fill out personal information such as name, address, and date of birth

03

Provide information about the drug treatment program you were previously enrolled in

04

Explain the reason for withdrawing from the program

05

Sign and date the form before submitting it

Who needs withdrawn national drug treatment?

01

Individuals who have been enrolled in a national drug treatment program and wish to withdraw from it

02

People who have decided to discontinue their participation in a drug treatment program and need to formally withdraw

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What is withdrawn national drug treatment?

Withdrawn national drug treatment refers to a form used to report any discontinued or withdrawn drug treatments.

Who is required to file withdrawn national drug treatment?

Healthcare providers, pharmaceutical companies, or any entity involved in drug treatments may be required to file withdrawn national drug treatment.

How to fill out withdrawn national drug treatment?

Withdrawn national drug treatment form can be filled out electronically or manually, providing details about the withdrawn drug treatment.

What is the purpose of withdrawn national drug treatment?

The purpose of withdrawn national drug treatment is to track and document any withdrawn drug treatments for regulatory and safety purposes.

What information must be reported on withdrawn national drug treatment?

Information such as the name of the drug treatment, reason for withdrawal, date of withdrawal, and potential side effects must be reported on withdrawn national drug treatment.

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