You are here

BEEHIVE Buprenorphine Program Tools

January 1, 2009

University of California, San Francisco

buprenorphine information sheet

This collection contains the tools, forms, and resources developed or utilized by the UCSF BEEHIVE program (integrated buprenorphine–HIV/AIDS program), a participant in the HRSA SPNS Buprenorphine project.

  • Treatment Materials:
    • Authorization to Exchange Health Information
    • Consent to Treatment with Buprenorphine
    • Take-Home Dose Agreement
    • Documentation of Clinical Eligibility 
    • Worksheet for DSM–IV Criteria for Diagnosis of Opioid Dependence
    • Prescribers’ Direct Dispensing Log Information
  • Recruitment Materials:
    • San Francisco DPH’s Integrated Buprenorphine Intervention Services Brochure
    • Patient Brochure
    • Patient Flyer
    • Program Exam Room Laminate Card
  • Protocols:
    • Program Description
    • Provider–Patient Expectations
    • Referral Procedures for HIV/AIDS Patients
    • Clinical Guidelines for Prescribing Buprenorphine in the Office-Based Treatment of Opioid Dependence
    • Jail Health Services Buprenorphine Inventory
Total views: 3,737