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Before Prescribing Narcotics for Pain Management, Consider ISMS’ Resource – a Patient-Doctor Agreement
Posted on: 8/16/2017

We have heard from numerous members seeking a sample patient-doctor agreement that physicians can employ prior to prescribing controlled substances.  

We heard you! ISMS' new Model Pain Management Agreement is now available for download.

This pact contains 22 conditions that patients must promise to meet in order to receive a prescription for a controlled substance. One of the conditions states that failure to comply may result in termination from a practice.

This model agreement can be used for both new and existing patients, and requires signatures of the patient, the physician and a witness.

If you have questions, please contact the ISMS Legal Department at 800-782-4767 or send an email.


This ISMS medical legal guideline is a member provided benefit and is password protected.

If you need to request a username and password, contact online support at 888-476-7776 or onlinehelp@isms.org between 8:30 a.m. and 4:45 p.m. After-hours requests are answered promptly the next business day. You may also register online or retrieve your username or password.



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