PENNSYLVANIA · CONTRACT FOR CARE · DOCUMENT RECORD
Pain & Spine Specialists: document versus identified state authority
Document: Informed Consent for Treatment within Opioid Alternative patient packet. Version: 2022 appears in filename; printed revision not established.
Status: Historical public group packet; Pennsylvania office use unconfirmed.
This multi-state branded, 28-page public packet has opioid consent on PDF pages 25–27. Current intake links an online form. The PDF’s filename is not proof of an effective date or current Pennsylvania use.
Read the complete original public document · Find the listed offices
Source-located terms
The table summarizes the clauses. Page references use PDF viewer pages, with clause numbers where printed. Follow the source link for the complete exact wording. Classifications are comparisons with the authority identified below, not determinations of enforceability or proof of patient outcomes.
| Source location | Document requirement or consequence — summary | Classification |
|---|---|---|
| PDF p.25 | Opioid trial continuation depends on benefit, function, side effects and adherence. | Authorized / contemplated; discretionary |
| PDF p.25 | Acknowledges risks, interactions, dependence and potential treatment changes. | Required subject / implementation discretionary |
| PDF p.26 | Take the prescribed dose; unauthorized changes may prevent early refills. | Required subject / implementation discretionary |
| PDF p.26 | One opioid prescriber; outside prescriptions need approval; no after-hours medication requests. | Institution-specific policy |
| PDF p.26 | Use one pharmacy and notify the physician if it changes. | Institution-specific policy |
| PDF p.26 | Authorize diagnostic and treatment discussions with pharmacists and treating providers. | Unresolved / legal review |
| PDF p.27 | Submit to random pill counts and urine or blood tests. | Broader than identified authority |
| PDF p.27 | Unauthorized substances may prompt addiction assessment and end opioid prescriptions. | Required subject / implementation discretionary |
| PDF p.27 | Failure to attend prescribed physical therapy may end opioid medications. | Institution-specific policy |
| PDF p.27 | Periodic reassessment may lead to weaning or another treatment change. | Authorized / contemplated; discretionary |
| PDF p.27 | No sharing; lost or stolen medication may go unreplaced; nonadherence may lead to discharge. | Required subject / implementation discretionary |
What the government requirement establishes
35 Pa.C.S. §52B02 requires covered treatment agreements to address goals, medically necessary targeted testing consent, prescribed use, no sharing, other controlled substances, reasons for changing or stopping therapy and disposal. Subsections (c)–(e) address testing and documented exceptions. Those required subjects do not make every facility-specific deadline, fee, restriction or discharge outcome mandatory.
28 Pa. Code §26.4 addresses testing, alternative testing for medical necessity, agreement termination and continuity of care. DOH implementation guidance says Act 112 does not require a particular pharmacy or targeted blood testing. Specific program, payer, privacy, professional or consent authorities may require further review; none are inferred from a form’s introductory assertion that laws apply.
Current intake and policy evidence
The practice now links an online intake form. A public new-patient policy describes an opioid agreement, random monitoring, discretionary discharge and a $75 missed-visit charge. That policy page identifies Maryland in its introduction; identical application at every Pennsylvania office has not been established.
Refusal, inability to comply and current use
The tables report consequences expressly described by the source, including possible prescribing cessation, medication gaps, rescheduling or dismissal where stated. They do not establish what happened to a particular patient. Current signed copies, exception policies, accommodations, taper/transfer procedures and office-specific practice confirmation remain needed. Unresolved privacy, cannabis, payment or legal-scope questions remain for legal review.
Practice: correct this record or supply the current version
Patient or practice: submit a contract, policy or newer version
Research date: October 12, 2026. Methodology and version history.