Medical and Dental Medication Form

This Notification Is To Inform You That

Name Of Shelby County Veterans Participant

Is currently a Shelby County Veterans Court participant and is a recovering addict / alcoholic. As part of a structured, judicially supervised treatment program, the Veterans Court participants are frequently subjected to random drug testing. Therefore, all medications and treatment procedures should be prescribed with this information in mind.

Please Specify Medication Type And Dosage

"The Small Expense Of Restoring An Individual To Health And Usefulness Is Returned Manifold."
--- Dr. Charles H. Mayo

Are you a Robot ?
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