Evidence status: CURRENT AGREEMENT DEFINITION AND POLICY BOUNDARY. Delaware requires a signed Treatment Agreement for covered chronic-pain patients, but the regulation distinguishes the existence of the agreement from optional terms that a practitioner may choose to include.

What is mandatory

The agreement must be written, signed by the practitioner and patient or patient proxy, and made part of the medical record.

Terms Delaware says the agreement may include

At the practitioner’s discretion, the Treatment Agreement may include:

• Medication use at the prescribed dose and frequency.
• A protocol for lost prescriptions and early refills.
• Reasons medication therapy may be reevaluated, tapered, or discontinued.
• A requirement that chronic-pain prescriptions come from one practitioner or a limited agreed-upon group of practitioners.
• An agreement not to abuse alcohol or use medically unauthorized substances or medications.
• Notice that agreement violations may result in a changed treatment plan, pain-specialist referral, or addiction-treatment referral.
• A requirement for random fluid drug screens at intervals chosen by the practitioner but not less than every six months.

Mandatory monitoring can exist outside the clause list

Although the definition says these agreement terms may be included at the practitioner’s discretion, Section 9.8 independently requires chronic-pain patients to receive fluid drug screening at least every six months. The monitoring requirement therefore exists even if a particular agreement phrases the clause differently.

Do not convert optional clauses into universal contract terms

Delaware’s regulation does not say that every agreement must use identical language for lost medication, early refills, alcohol, single-prescriber sourcing, or automatic consequences. Those provisions can be practice choices within the broader state framework.

Primary source

• Delaware Uniform Controlled Substances Act Regulations — Treatment Agreement definition

Reviewed: October 5, 2026.