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Buprenorphine
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On-Line Notification Form to Increase Patient Limit

If you submitted your original notification not less than one year ago, and your waiver has been certified, and you have an e-mail address, please enter the following three pieces of information:

To bring up a form pre-filled with the information we currently have on file for you, use the Get On-Line Form button below.

  • Get on-line form.
  • Review items 1 through 11.
  • Please make any necessary corrections to the information on the form.
  • Submit the form by using the Submit Waiver Notification button in box 12.
  • You will receive and e-mail saying that your submission has been received - RESPOND to this e-mail to complete the submission process.

 


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