SAFE USE
I agree that I will use my medication at a rate no greater than the prescribed rate and that the use of
my medicine at a greater rate could pose a serious health risk and my being without medication fora period of time.
I will swallow this pain medication whole and not break,crush,or chew;as taking a broken,crushed,chewed,dissolved,
or an injection of this pain medication is very dangerous because I could receive the full daily dose too quickly.
I will not abruptly stop taking my pain medication. Proper Handling and Disposal
I understand that accidental use by a child is a medical emergency and can result in death.
If a child accidentally takes this pain medication,
I should get emergency help right away,even if the child is not having any side effects.
I will safeguard my medication from loss or theft. Lost or stolen medications
will not be replaced without a police report to validate the incident.
I will not share or sell my medication,and I will take every possible precaution
to make sure no one else has access to it whether at home or at work.
I understand if I stop taking this pain medication, as coordinated by my doctor.will return the unused portion to my pharmacy for disposal.
I agree to follow these guidelines that have been fully explained to me.All my questions and concerns regarding treatment have been adequately
answered.A copy of this document has been given to me.