| Suboxone Forms |
Fill out the following forms out prior to your scheduled appointment.
|
Methadone Transfer Consent |
Click To Download |
| This form must be filled out by the patient if he/she is on Methadone Treatment. |
New Patient Registration Form |
Click To Download |
| This form is for Intake and Pharmacy information. Please fill this out and bring it to your scheduled appointment |
Attendance Policy Form |
Click To Download |
| It is essential that you fill out the attendance policy |
Patient Privacy Consent Form (For HIPAA Purpose) |
Click To
Download |
| This form entitles Suffolk Behavioral Medicine to contact the patient’s previous physician, therapist and/or any relatives with the patients consent. |
Insurance Information Form |
Click To
Download |
| This form is for new patients or current patients whose insurance may have changed or expired. Please fill this out and bring it to your scheduled appointment |
Suboxone :631-513-1672 
