CyborgGold
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- Joined
- Jan 25, 2012
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I have a patient lined up to be my first... and I'm not sure about something. The patient said they may need up to 4oz a week, and this seems to be a verry high amount of medication for one person, at least from this rookies POV. I wrote up a draft for an agreement form to have my patients sign just in case they are doing anything illegal, to hopefully make it clear to any authorities that my intent is only to supply a patient with their meds for personal use, and that they agreed that was my role as well. Below is the agreement, let me know what you think. If there are any lawyers that have advise on this subject, I would greatly appreciate their input. One I have the money for one I will be hiring one of my own for this type of thing, but until then I have to do what I can.
Patient and Caregiver Agreement
I _______________________(caregiver) agree to provide _________________________ (patient) with medication as his/her caregiver. I agree to keep all information about my patient, his/her ailments, and his/her medication use private from any third party. I agree that it is my responsibility as caregiver to deliver medication to a mutually agreed upon location. I agree to keep my patient informed about any situations that may occur which may interfere with my ability to provide medication.
Signature_____________________________________
I _________________________ (patient) agree to keep all information about _________________________ (caregiver) that I may obtain from our arrangement private from any third party without consent from my caregiver. I agree that the supply of medication provided by my caregiver is intended solely for my own personal use. I agree that I will not use or distribute my medication in any way that would constitute an illegal act.
Signature_____________________________________
Patient and Caregiver Agreement
I _______________________(caregiver) agree to provide _________________________ (patient) with medication as his/her caregiver. I agree to keep all information about my patient, his/her ailments, and his/her medication use private from any third party. I agree that it is my responsibility as caregiver to deliver medication to a mutually agreed upon location. I agree to keep my patient informed about any situations that may occur which may interfere with my ability to provide medication.
Signature_____________________________________
I _________________________ (patient) agree to keep all information about _________________________ (caregiver) that I may obtain from our arrangement private from any third party without consent from my caregiver. I agree that the supply of medication provided by my caregiver is intended solely for my own personal use. I agree that I will not use or distribute my medication in any way that would constitute an illegal act.
Signature_____________________________________