Based on your care plan, your ZoomCare Provider may ask you to fill out an agreement before prescribing a controlled substance.
If your Provider has asked you to fill out this form, here's what you need to do:
1. Download the form attached below.
2. Fill out the form. You can either use a pdf editor to select your answers digitally or print the document and take a picture of your answers.
3. Respond to the email from "firstname.lastname@example.org" with your attached documents or go to your ZoomCare message center to submit the forms