Subacute Opioid Request Form

Document Information
  How to complete a fillable form.
Title Subacute Opioid Request Form

Use this form to request opioid coverage between 6 weeks to 12 weeks from the date of injury or surgery.

Document number F252-097-000
How to get this document
Alt Language(s)
Valid dates 01/2015
Contact information Office of the Medical Director
Websites Prescribing Opioids to Treat Pain in Injured Workers

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