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Patients will be required to read Clinic Policies and give an electronic signature to obtain any forms or reserve an appointment. This  website is not HIPPA secure; and thus, cannot accept or exchange ANY sensitive information or private data.

MEDICATION MANAGEMENT CONSULTATION

Because of the type of medications prescribed, SxM has a strict opioid and controlled substance policy.  To be considered for prescriptions or medication management, SxM requires the following:

1. •Patients must have an initial consultation before he/she is considered for this service.
   

2. •Patients must adhere to all clinic polices, contracts and agreements.
   

3. •Patients must sign a controlled substance/opiate contract, participate in controlled substance/opiate education, and undergo periodic laboratory studies, including toxicology.
   

4. •Evaluation by behavioral medicine may be required if there is a history of depression, anxiety, high opioid use and/or substance abuse.
   

5. •Patients and providers agree that prescriptions are obtained from one physician and one pharmacy.
   

6. •If the patient cannot meet all of the requirements, he/she will be discharged from the SxM clinic and all subsequent care will continue with the PCP.
   

We are available to discuss pain or symptoms concerns you may have about your patient.  To initiate an appointment, complete the referral forms below and forward all the supporting documentation.  All documents may be faxed 1888.SXMMED0 (888.796.6330).   Please contact us if you have any questions

phone: 1888.SXMMED1 (888.796.6331).

Forms

1. •    SxM CONSULTATION REFERRAL FORM
   

2.