Transcription of Physician Questionnaire - cpso.on.ca
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Physician Questionnaire - cpso.on.ca
Physician Questionnaire The purpose of this Questionnaire is to provide the Methadone Committee with the most current information about you and your practice. The information enclosed will be reviewed by the Committee and individuals appointed, to discuss and/or review your practice, and by staff who support the Committee. NAME:: CPSO#: DATE OF BIRTH: SEX: MEDICAL SCHOOL: YEAR OBTAINED: SPECIALTY: YEAR OBTAINED: ---------------------------------------- ---------------------------------------- ---------------------------------------- ---------------- PLEASE PRINT LEGIBLY USING BLACK INK ONLY I. What is your practice status? What type of methadone exemption have you received from Health Canada?
Physician Questionnaire 8. How are prescriptions issued and transmitted? Shared EMR Fax Other: _____ Urine Collection
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ORDERING URINE TESTING FOR, Guidelines, Ordering Urine Testing for Drugs, Abuse: Targeted and Screening Tests, GENERAL, Urine, Of Urine and Faeces in Crop, Of Urine and Faeces in Crop Production, CATHETER CARE GUIDELINES, Husbandry Guidelines, Service Availability andReadiness, Service Availability and Readiness Assessment SARA