Examples of Opioid Informed Consent & Agreement

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Opioid planning and management: informed consent and agreements

Informed consent for opioid therapy of pain and documentation of the treatment plan in the form of an opioid treatment agreement (OTA), serve conceptually separate functions. However, they are usually included in one document. Samples OTAs are below and can be adapted to the preferences of individual clinicians:

• Informed Consent and Treatment Agreement- Savage-Cheatle 2012(pdf)
• Opioid Treatment Agreement-Veterans Administration, 2010 (pdf)
• Opioid Treatment Agreement, sample – American Academy of Pain Medicine, 2000 (pdf)