Patient Abandonment and Forced Opioid Taper Questionnaire 
We, The Doctor Patient Forum, are a small nonprofit organization. Our mission is to advocate, educate, and protect the sanctity of the doctor-patient relationship, while equipping our constituents with resources and tools to maintain quality-filled lives. One of our main missions is to raise awareness to the current issue of patient abandonment and forced opioid tapers. You can find us at
We are collecting data/stories from patients who were on daily opioid therapy for pain and are currently no longer receiving a prescription from their provider, are currently in the process of being force tapered by their provider, were force tapered by their provider down to a lower dose than they were previously given, or were abruptly cut off. Please do not fill out this form if you lost your provider and were able to find a new one at the same dose you were given. Please do not fill out this form if you have initiated an opioid taper.
Even if you have already responded to a post about this or e-mailed your patient story to Bev, please fill out this form for accuracy.

Who should fill out this form? 

1. Those who were receiving daily opioid therapy for pain, were dismissed from their provider, and have been unable to find a new provider to prescribe daily opioids. Some examples may be for failed UDT, failed pill count, being labeled as "too complicated," etc.

2. Those who were receiving daily opioid therapy for pain, their provider no longer practices or sees chronic pain patients, and have been unable to find a new provider. This can also include those whose provider suddenly discontinued their opioid prescription. Some examples may be DEA investigation, provider has passed away, or provider moved. 

3. Those who were receiving daily opioid therapy for pain and their provider stopped their medication cold turkey, is in the process of force tapering (tapering without patient consent or approval) them. This can be a sudden discontinuation, a rapid or a slow taper. 

4. Those who were on daily opioids for pain and were force tapered down to a lower strength or MME.

5. Those who were stable on daily opioids for pain and were told their only option was Suboxone/Subutex (buprenorphine/naloxone).

Please understand, we are not collecting this information to help you find a new provider. Unfortunately, that is becoming increasingly more difficult to do.

 We are collecting this information with the hope that possibly:

1. Media will cover this issue of patient abandonment and forced opioid tapers.
2. This may lead to a formal study on patient abandonment and forced opioid tapers on both the state and national level so resources can be allocated to help these patients.
3. This information may help us convince lawmakers that patient abandonment and forced tapers have reached a crisis level.

The purpose of gathering this information is to demonstrate the following:

1.  Frequency with which patients are force tapered and/or abandoned.
2.  What circumstances have led to patients being force tapered and/or abandoned. 
3.  How often resources are provided to patients for continuity of care.

We are requesting patients voluntarily submit ONLY as much information as they are comfortable providing.

By filling out this form you are giving your consent to allow individuals involved with opioid policy, journalists, legislators, and policy makers to view a de-identified version of the data. 

De-identified data is defined by HIPAA as "health information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual.”

You will have the option of using initials or a pseudonym. If you wish to not use your name but your e-mail address includes your name, please create a new e-mail address that doesn't contain identifying information. 
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