*FOR NEW PATIENTS ONLY

    Please fill out the form below to update us on your treatment progress. Once we receive your response, your doctor/provider will continue your treatment or make dose adjustments if necessary.

    Suboxone FILM (buprenorphine/naloxone) - 8mgSuboxone FILM (buprenorphine/naloxone) - 4mgSuboxone TABLET (buprenorphine/naloxone) - 8mgSuboxone TABLET (buprenorphine/naloxone) - 4mgSubutex TABLET (buprenorphine only) - 8mgSubutex TABLET (buprenorphine only) - 4mg
    I declare that the info I’ve provided is accurate & complete