Chronic Opioid Request Form


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Title Chronic Opioid Request Form
Description

Use this form to request opioid coverage beyond 12 weeks from the date of injury or surgery, or every 90 days for chronic opioid therapy.

Document number F252-091-000
How to get this document
Alt Language(s)
Valid dates 07/2013
Contact information Office of the Medical Director
Websites

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