Documents

Key Care Documents

• Diabetes & Obesity: Weight Watcher's Referral Form
• Consultant Helper Sheet
• Vitamin K Foods

Formularies

• TennCare Preferred Drug List
• TennCare Pharmacy Program Documents
  
  
• MED Formulary
• PMAP (Patient Medication Assistance Program)
  *Above two links available only on MED intranet*
  
  
• Aetna Formulary
• BlueCross BlueShield Pharmacy - Group & Individual Plan Members
• BlueCross BlueShield Pharmacy - BlueCare Members
• BlueCross BlueShield Pharmacy - TennCare Select Members
  

Controlled Substances Documents

Official MEDPLEX Pain Documents

• Chronic Pain Contract
• Pain Clinic Visit & Medication Record

TN Board of Medical Examiners Policies

• Authority of Physician to Prescribe for the Treatment of Pain
• Management of Prescribing (with Emphasis on Addictive or Dependence Producing Drugs)

Controlled Rx Record Keeping

NJEM Nov, 2003 - Opioid Therapy for Chronic Pain

Narcotic Contracts

• Consent & Agreement for Opioid Maintenance Therapy for Malignant & Non-malignant Pain (source?)
• Med-Plex Opioid Therapy Contract (derived from NJEM?)
• NJEM Opioid Therapy Flowchart
• JCA Opioid Therapy Contract
• Semmes Murphy Clinic Prescription Sheets

Requirements for Referrals to Rheumatology & Gastroenterology

• Rheumatology
• Gastroenterology

Medical Assistance Program - Drugs Available

Please see link on MED Intranet homepage* for the up-to-date listing.
*Above link available only on MED intranet*

Contact Us

MedPlex Clinic

880 Madison Ave
Memphis, TN 38103
Main Phone No: 901-545-7185