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Methadone Dispensing Form - OCPInfo.com

Methadone Dispensing Notification Form The Methadone Maintenance Treatment (MMT) and Dispensing Policy requires the owner/designated manager (DM) of a pharmacy to inform the College within seven days of starting to dispense Methadone for either Methadone maintenance treatment (MMT; for opioid addiction/dependence) or for pain/analgesia, and of changes in this status. New Initial Notification Pharmacy Information Change AOwner of Pharmacy/Corporation Name: Accreditation Number: Name of Pharmacy (by which the pharmacy is known to the public): Postal Code: Start Date of Methadone Dispensing : Stop Date of Methadone Dispensing : Hours of Operation Change B Sunday Monday Tuesday Wednesday Thursday Friday Saturday Holidays The DM must be trained via the CAMH Opioid Dependence Treatment (ODT) Core Course or approved course within six months of beginning this practice.

Methadone Dispensing Notification Form . The . Methadone Maintenance Treatment (MMT) and Dispensing Policy. requires the owner/designated manager of a (DM)

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