Buprenorphine Prescription Log (To Be Kept In Physician Master File Or Buprenorphine-Treated Patients)

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Buprenorphine Prescription Log
(to be kept in physician master file or buprenorphine-treated patients)
Number
Date
Patient Name
Medication/Dose
#Pills/Refills
Date Discharged
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
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