Consent For Chronic Opioid Therapy Mobile App

This decision was made because my condition is serious or other treatments have not helped my pain. I am aware that the use of such medicine has certain risks associated with it, including, but not limited to: sleepiness or drowsiness, constipation, nausea itching vomiting, dizziness, allergic reaction, slowing of breathing rate, slowing of reflexes or reaction time, physical dependence, tolerance to analgesia, addiction and possibility that the medicine will not provide complete pain relief. I will tell my doctor about all other medicines and treatments that I am receiving. I will not be involved in any activity that may be dangerous to me or someone else if I feel drowsy or am not thinking clearly. I am aware that even if I do not notice it, my reflexes and reaction time might still be slowed. Such activities include, but are not limited to: using heavy equipment or a motor vehicle, working in unprotected heights or being responsible for another individual who is unable to care for himself or herself.

Industry: Health Care & Social Services Pharmacies

  • Apple
    iPhone, iPad
  • Android
  • Window

Why Customers Love GoCanvas

Reduces paperwork
Tracks jobs & expenses
Shows real-time data
Affordable plans
How It Works
I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.

Dave Kramer

PennLine Service

Want to see how GoCanvas can help your business?

Request Demo

Join Thousands of Businesses Saving Time with GoCanvas