Terms and Conditions

1. I agree to be civil and never to intimidate, threaten, or verbally abuse www.addictionology.center group staff. We understand and encourage being open and showing emotion but do not tolerate hostility.|
2. I agree never to sell, share or give any of my medication to another person. We can’t allow medication that we prescribe to be used in any way other than directed by your medical provider. Sharing or selling medication is dangerous, illegal, and cause for termination of further prescriptions. We’re always happy to work with your friend or loved-one to enroll in treatment instead.
3. I agree to take my prescribed medication exactly as directed and to notify my provider if directions are unclear or I’m unable to follow them for any reason. Never improvise or guess! We’re always here to support you, and so is your pharmacist. Do not increase or decrease your dose unless directed to do so by your provider.
4. I agree to notify my provider anytime a new medication is prescribed by another medical provider. We must review all other medication for safety when prescribed along with the treatment that we provide, and we consider their possible effect on drug test results.
5. I agree to provide complete and accurate answers to my provider. Your provider is a trained specialist but can’t read your mind! We make medical decisions to maximize your comfort and safety, and we rely on what you tell us to accomplish this. If we can’t rely on the information you provide us, it may be unsafe to continue your treatment.
6. I agree to provide my own sample of urine or saliva for drug testing promptly within 24 hours when directed. Drug testing helps you to be accountable to your goals for treatment, and it helps us understand how well your treatment is working for you. We will not continue treatment if drug screens are being delayed, forged, tampered, or deliberately or repeatedly caused to be inaccurate.
7. I agree not to fill any prescription for an opioid medication unless it is prescribed or specifically authorized by my provider, except in a medical emergency. Other opioid medications are crucial for us to know about due to their impact on your treatment.
8. I agree to provide at least 24 hours’ notice to reschedule an appointment, and I understand that medication refills will only be provided during scheduled appointments. We will never provide a buprenorphine refill outside of a video-appointment during business hours. Please plan accordingly.
9. I agree to work with my provider toward the goal of stopping all illicit drug use. We ask all patients to work with us toward this goal which, based on your unique treatment plan and preferences may include working with a counselor, therapist, support group, mental health provider, or another type of treatment program to compliment care by your provider. Our model works very well for most patients, but in the case where a patient is not progressing toward treatment goals we would refer to a more suitable program and discontinue care at this clinic.
10. I agree to notify www.addictionology.center group in advance when I am going to be unavailable to complete a random drug screen or medication count. We want you to be free to travel and enjoy your life. Give us a heads-up in advance when you will be unreachable or unable to complete a drug screen, and we’ll accommodate all such reasonable requests. Exceptions to the advance notice requirement will be made for documented emergencies at the medical provider’s discretion.
11. I agree to complete a medication count promptly within 24 hours when directed.

Periodically we will verify that you have the correct number of tablets or films remaining which helps us understand that you’re taking and storing the medication safely as directed. Counts may be performed by video or photograph, per instruction of staff.

12. I agree to store my medication in a safe, secure place where it’s not accessible to others and especially not accessible to children. In the event of medication loss or theft, a police report must be filed before we can consider replacing lost medication. A child who ingests buprenorphine may die from opioid overdose. If you are ever concerned about having a safe place to store your medication, talk to your provider who will advise you.
13. I agree to provide prompt notice to www.addictionology.center group of any change in my contact or payment information. We want to avoid any interruptions in your care that may be caused by difficulty reaching you, covering costs, or sending drug tests to old or invalid addresses. We won’t know of changes unless you tell us, so do keep us informed.
14. I agree to read all materials and ask any questions needed to help me understand them before signing anything. Agreements like this one are designed to ensure you know all about our program and what we need from you to continue a safe, convenient, and long-lasting treatment relationship.
15. I agree not to openly display or use an illegal substance during my interactions with staff or providers. We’re happy to be able to serve patients at our clinic. Visits are professional interactions, and we ask that they be treated as such. Please help us create an environment of respect and professional dignity during your visits.
16. I understand that my treatment plan is determined by my medical provider and will be modified based on my changing situation and needs. Your provider will develop the treatment plan collaboratively with you and will respect your preferences and decisions to every extent possible. Situations may occur when your preferred treatment is no longer medically safe. Failure to abide by this treatment agreement may lead your provider to determine that office-based buprenorphine is no longer safe and to refer to a different treatment setting.
17. I understand that www.addictionology.center group does not directly provide any medical care. My physician provider provides medical assessment, treatment, and needed support for that treatment which may include referral when needed. There are several options and settings for treatment of problematic opioid use, and payment does not obligate any provider to recommend or provide a specific form of treatment such as buprenorphine. The appropriate treatment is always at the discretion of your provider.

I agree to adhere to all the conditions above. I understand the policies listed above and I agree to comply with this aspect of my treatment plan. I understand that the failure to comply with any of the conditions above will be grounds for the termination of my treatment with www.addictionology.center group.

I certify that I have carefully read, understand, and agree to the terms above, and I consent fully and voluntarily to this agreement. The undersigned is the patient, the patient’s legal representative or is authorized by the patient to execute this form and accepts its terms.

Code of Ethics

All Users of the www.addictionology.center website acknowledge and accept the Code of Ethics Policy, which may be updated.

All Center staff members (which includes contractors and interns)shall perform their duties in the context of this Code of Ethics and shall observe all relevant rules, laws, and standards.

• All staff members will review this Code of Ethics and will abide by these principles.
• All patients will this Code of Ethics and will abide by these principles.
• This Code of Ethics is available to all stakeholders upon request and is posted on the Center’s website.
• Patients will be advised of the channels that are available to them for reporting ethical violations in the patient handbook and in the orientation session.

Confidential Information

The use of confidential information obtained as a consequence of employment or involvement as a contractor or internwith Center must be limited to the proper conduct of Center’s business.  All information about our patients is confidential and must never be disclosed to outsiders, except with the patient’s written authorization or as allowed under federal and/or state law.  Neither Center nor any member of the Board of Directors or the staff may use, or permit others to use, confidential information for the purpose of furthering a private interest or as a means of making a profit.

Responsibility to Patients

This principal refers to practices and procedures of individual and/or group counseling relationships.

• The primary obligation of Center’s staff membersis to respect the integrity and promote the welfare of the patient, whether the patient is assisted individually or in a group relationship.  In a group setting, staff members are also responsible for taking reasonable precautions to protect individuals from physical and/or psychological trauma resulting from interaction within the group.
• The counseling relationship and information resulting from this relationship must be kept CONFIDENTIAL, consistent with the obligations of all Center staff.  In a group counseling setting the facilitator must set a norm of CONFIDENTIALITY regarding all group participants’ disclosures.
• If a patient is already in a counseling relationship with another professional, staff members must attempt contact with that professional after obtaining aproper authorization to disclose protected health information for the exchange of relevant information regarding the patient in question. The contact, or the attempts to contact, shall be documented in the clinical record.
• When the patient’s condition indicates that there is a clear and imminent danger to the patient or others, staff must inform responsible authorities (Duty to Warn) after consultation with the Executive Director, or his or her manager/
• The solicitation or acceptance of commissions, fees, or anything of monetary value on the part of a staff member from patients, suppliers, or any other source as compensation for services routinely rendered to patients is not permitted.
• Records of the counseling relationship, including interview notes, test data, correspondence, progress notes, and other documents are to be considered professional information for use in counseling and they are considered a part of the records of the Center.
• Revelation to individuals or organizations of a patient’s protected health information shall occur with the written consent of the patient unless the state or federal government allows or requires the release of the information without the patient’s written consent. Patients are given a copy of the Center’s Notice of Privacy Practices which describes how clinical information about them may be used and disclosed with and without their written authorization.
• The use of data derived from a counseling relationship for purposes of counselor training or research shall be confined to content that can be disguised to ensure the full protection of the identity of the patient.
• In recognition of the fact that the relationship between staff members and patients is one in which the utmost discretion, good judgment, and ethical behavior are of paramount importance, certain restrictions as to the scope of that relationship need to be carefully and strictly outlined and adhered to by all staff. This needs to be done in order to ensure the relationship’s integrity and therapeutic soundness. Therefore, activities such as in-kind payment for services (i.e. a patient offering free meals at his or her restaurant to a counselor in exchange for counseling services), and financial transactions between staff members and patients such as lending/borrowing money, entering into loan agreements, formation of social relationships secondary to the ongoing therapeutic relationship, or the sponsoring of active patients are all considered to be unethical and are not to be engaged in by the staff member. Giving or lending items to patients such as tobacco products is also prohibited for all staff. Similarly, if any staff member becomes aware of a colleague engaging in such activities, it is his or her responsibility to bring such issues and concerns to the Executive Director immediately.

Ethical Conflicts

• If a staff member determines an inability to be of professional assistance to the patient or perceives an ethical conflict, the staff member must bring this situation and its concerns to his or her supervisor.  The supervisor will determine the most appropriate action to be taken.
• Staff members who have relatives, close friends, and/or business acquaintances who become Center patients will excuse themselves from taking an active part in the treatment plan of such relatives, friends, and acquaintances.  This is necessary to ensure objectivity in the service to such individuals.

Responsibility to Colleagues

Center staff should treat colleagues with respect, courtesy, fairness, and good faith.

• Staff should cooperate with colleagues to promote professional interests and concerns.
• Staff should respect ethical confidences shared by colleagues in the course of their professional relationships and transactions.
• Staff should create and maintain conditions of practice that facilitate ethical and competent professional performance by colleagues.
• Any staff member having knowledge of unethical practices on the part of another colleague shall report such practices to the Center’s Executive Director.
• Staff members who replace or are replaced by a colleague in a professional practice should act with consideration for the interest, character, and reputation of that colleague.
• Staff members should extend to colleagues of other professions the same respect and cooperation that is extended to their staff colleagues.
• Staff members may not use the workplace for proselytizing for religious, political, or economic purposes.

Business Transactions

All staff membersshould avoid representing Center in any transaction with any person, firm, corporation, or organization with which the staff member, or any member of the staff member’s family, has any material connection or in which he or she owns a substantial interest.  Any such conflict needs to be brought to the attention of his or her supervisor.

Staff members who serve as an officer or board members of any other organization, corporation, association, government entity, etc. shall not represent the Center in any transactions with that same organization, corporation, association, or government entity in any contractual relationship without specific approval of the Executive Director.

All transactions with outside suppliers should be conducted on a business-like basis in the best interest of the Center.  Decisions should be governed by a customer-business relationship and not by personal friendship.

Civic Activities:  Active participation by staff members in religious, community, professional or charitable organizations is encouraged.  Approval is not required to participate in or accept appointment as a trustee, director or officer of a non-profit organization unless there is some other potential conflict of interest between the organization and Center.

Political Activities: A staff member may participate in political activities on his or her own time and in accordance with his or her individual desires and political preferences.  However, it must be clear at all times that a staff member’s participation is done as an individual and not as a representative of Center.  Before a staff member becomes a candidate or appointee to a public office, the staff member must advise his or her supervisor.

Proprietary Knowledge: No staff member will share knowledge, facts, reports, written documents regarding Center methods, documents regarding procedures or operations, etc., without the expressed consent of the Executive Director.

Because the primary responsibility of the Center’s staff is to provide clinical services to Center patients in accordance with best practices in addiction and mental health treatment, the Center discourages such outside activities as the facilitation of outside therapeutic groups, or any other activity that proves to be adversely affecting the employee’s job performance at Center.  It is the obligation of every staff member, when contemplating participating in such outside activities, to first bring these issues to the Executive Director for his or her consideration and appropriate recommendations.

Marketing Ethics

The Center Marketing Department, in addition to supporting and obeying laws and legal regulations pertaining to marketing and advertising, extends and broaden the application of high ethical standards.  Specifically, we will not knowingly make marketing claims or create advertising that contains:

• False or misleading statements or exaggerations
• Testimonials that do not reflect the real opinion of the individual(s) involved
• Price claims that are misleading
• Claims insufficiently supported or that distort the true meaning of practicable application of statements made by professional or scientific authority
• Statements, suggestions, or graphics offensive to public decency or minority segments of the population.

We recognize there are areas that are subject to honestly different interpretations and judgments.  Nevertheless, we agree not to use advertising that is in poor or questionable taste or that is deliberately insensitive.  These principles are based on the belief that sound and ethical practice is good business.  Confidence and respect are indispensable to our success and our relationship with clients and the public at large is dependent upon good faith.

Outside Conflicts of Interest

No outside activity must interfere or conflict with the interest of the Center.  Acceptance of outside employment, election to directorships of other organizations, and participation in the affairs of the outside organizations carry possibilities of conflict of interest and shall be discussed with the Executive Director before acceptance.

No staff member of the Center will be a director or officer of any other treatment facility or any other entity, which competes directly or indirectly with the Center without the prior approval of the Executive Director.

Specified types of outside activities that raise conflict of interest or other difficult situations include, but are not limited to:

• Being employed or contracted by a business, or personally engaging in any activity that is competitive with the Center without specific approval of the Executive Director.
• Using Center equipment, supplies, files, letterhead, or facilities for purposes other than Center-related activities.
• Personal conduct involving the use of mood-altering substances; gambling or other activities during or outside of work hours may prove embarrassing or reflect adversely upon the Center or the professional staff member in the conduct of his or her duties at the Center.
• Statements or circumstances that may imply sponsorship or support by the Center of an outside employer or of a political, charitable, civic, religious, or similar organization when such is not the case.

Professional Competence and Integrity

Center staff members must be dedicated to maintaining high standards of bothprofessional competence and integrity andwill do the following:

• Staff memberswho:are convicted of felonies, are convicted of misdemeanors, engage in conduct which could lead to conviction of felonies or misdemeanors related to their qualifications or functions, are expelled from other professional organizations, or have their license or certificates suspended or revoked must report such activities or actions immediately to the Executive Director.
• Center staff members recovering from a substance-use disorder, other than nicotine-related or caffeine-related disorders, must document continuous abstinence under independent living conditions or recovery housing for the immediate past two years prior to providing clinical services and must report any relapse during their time of providing clinical services at Center.
• Staff memberswill seek appropriate professional assistance for their own personal problems or conflicts that are likely to impair their work performance or their clinical judgment.
• Staff members will not engage in sexual relationships with current or past patients at any time.
• Staff memberswho have direct contactwith a particular patient or former patient of any Center program shallnot have, seek, or request a sexual relationship or sexual contact with that patient or former patient at any time.
• Staff memberswho have not had direct contactwith a particular patient or former patient of any Center program should not have, seek, or request a sexual relationship or sexual contact with that patient or former patient for a period of at least two years following that patient’s receipt of Center services.
• All staff membersshall not have or seek to have a personal, professional, or business relationship or contact with any patientfor a period of at least two yearsfollowing the patient’s receipt of Center services.
• Relationships between staff members and current or former patients or clients within Twelve Step recovery fellowships and other fellowships are sometimes unavoidable. In such cases, the relationships are to be maintained at a group level rather than a one-on-one level. These guidelines apply to the time a current or former patient participates in any Center program and for the period established for personal relations as noted above.
• Staff memberswill not engage in verbal, emotional or behavioral harassment of patients, trainees or colleagues.
• Staff memberswill not attempt to diagnose, treat or advise on problems outside recognized boundaries of their competence.
• Under no circumstances, other than noted above,is a staff memberever to meet a patient, or former patient, or patient family member, outside of Center property unless participating in a Center sanctioned activity.  Additionally, no  staff membermay ever give a patient his or heror other Center past or current staff’spersonal cell phone number, home phone number, email address or any other means of contacting them outside of Center, including texting, social media resources (i.e. Facebook, MySpace, etc) within a two-year period following the patient’s discharge from treatment. Extenuating circumstances such as family member or associate known prior to starting into treatment may be an exception to this policy and counsel shallbe sought from the Executive Director regarding appropriateness of actions.
• Staff memberswill attempt to prevent the distortion or misuses of their clinical findings.
• Staff memberswill be aware that because of their ability to influence and alter the lives of others, they must exercise special care when making public their professional recommendations and opinions through testimony or other public statements.

Responsibility to the Profession

Staff members respect the rights and responsibilities of professional colleagues; and participate in activities that advance the goal of the profession.

• Staff members remain accountable to the standards of the profession when acting as members or employees of organizations.
• Staff membersrecognize a responsibility to participate in activities that contribute to a better community and society.
• Staff members are concerned with developing laws and regulations pertaining to their field that serve the public interest, and with altering such laws and regulations that are not in the public interest.
• Staff members recognize the need for continuing education and are open to new procedures and changes in expectations and values over time.
• Staff members recognize that personal problems and conflicts may interfere with professional effectiveness.  Accordingly, they refrain from undertaking any activity in which their personal problems are likely to lead to inadequate performance or harm to a patient or colleague.  If engaged in such activity when they become aware of their personal problems, it is the staff member’s obligation to bring this to the attention of his or her immediate supervisor so that a determination can be made as to whether they should suspend, terminate or limit the scope of their professional activity.

Witnessing of documents

Unless approved by the Executive Director, or designee, no staff member shall act as witness to any document, for example. a will or advance directive, for a patient except Center generated forms. See Notary Services Policy for more information.  No document for outside use may be generated without direct Executive Director approval and countersignature.

Candor with Management, Auditors, and Counsel

Staff membersare expected to maintain complete and open communication with management regarding Center matters.  Any staff memberdeliberately concealing information or misleading management, auditors, or counsel shall be sanctioned up to dismissal and referral to a prosecutor for possible criminal justice action.

Implementation of the Code of Ethics

Difficult questions of judgment may arise in connection with thisCode of Ethics.  If any doubt exists regarding the propriety of an action or activity, the employee should seek advice and written approval from the Executive Director.  All staff membersare expected to promptly report the existence of any of their relationships, interest, or actions, which might violate or appear to violate thisCode of Ethics.

Violations of the Code of Ethics

Any suspected violations of thisCode of Ethics shallbe referred to the Executive Director.  Violations of this Code of Ethics may be grounds for disciplinary action, up to and including dismissal and referral to a prosecutor for possible criminal justice action. In situations where infractions of the Code may have violated federal or state law, such infractions will be disclosed as appropriate, and reported to enforcement agencies as required.

Medical Disclaimer

As with all medical treatment, individual patients may have varied success and failure rates. Patient reviews and testimonials should never be interpreted as a statement on the effectiveness of a specific treatment for anyone else.