FORM-Pregnancy Consent Pregnancy Consent The FDA has not approved suboxone/buprenorphine as completely safe for use during pregnancy. The decision on whether or not to continue the medication during pregnancy must be made after a full and open discussion of the risks and benefits of that decision. It is important that you inform your doctor if you are now or intend to become pregnant. Suboxone/buprenorphine can be a way to maintain pregnancy as healthfully as possible while also stopping the use of the opiate of choice without triggering withdrawal symptoms that may cause a spontaneous abortion. Throughout the pregnancy, your infant could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the infant after the infant is born. Adequate advance planning will allow for the greatest physical and mental well-being of mother and infant.(Required)The FDA has not approved suboxone/buprenorphine as completely safe for use during pregnancy. The decision on whether or not to continue the medication during pregnancy must be made after a full and open discussion of the risks and benefits of that decision. It is important that you inform your doctor if you are now or intend to become pregnant. Suboxone/buprenorphine can be a way to maintain pregnancy as healthfully as possible while also stopping the use of the opiate of choice without triggering withdrawal symptoms that may cause a spontaneous abortion. Throughout the pregnancy, your infant could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the infant after the infant is born. Adequate advance planning will allow for the greatest physical and mental well-being of mother and infant. I understand and agree.Patient Name(Required) First Last Email(Required) Date of Birth(Required) Date(Required) NameThis field is for validation purposes and should be left unchanged. Δ
