This detailed benzodiazepine consent and therapy agreement is essential for clinics prescribing controlled medications like diazepam, lorazepam, clonazepam, or alprazolam. Designed for licensed functional, integrative, and primary care providers, it outlines treatment goals, side effect risks, safe-use expectations, refill protocols, and zero-tolerance policies for abuse, diversion, or noncompliance. It includes sections on tolerance, dependence, withdrawal, driving safety, pregnancy risks, random testing, pill counts, and prescription monitoring.

Download now to implement a compliant, legally protective benzodiazepine policy that reinforces patient safety and clinic accountability.