Buprenorphine Clinics in Wisconsin
We are putting together a directory of clinics that prescribe buprenorphine in Wisconsin. Our goal is to make referrals between clinics and referrals to clinics from the ED and inpatient settings much easier. We will share this information with healthcare organizations, community partners and patients looking for assistance. Our long-term goal is to include this information in the 2-1-1 directory (https://211wisconsin.communityos.org/ )

Your email and contact information will not be shared publicly.

Questions? Email Ezra Lyon (ezralyon@gmail.com).
The public-facing home for the directory is here:
 https://www.wisam-asam.org/page-1075435

Link to this form is here:
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Email *
What is your clinic name? *
What is your address?
 *
City *
State *
Zip code *
County *
Are you accepting new patients for treatment of opioid use disorder?
 *
What is your typical turn-around time for a new referral for opioid use disorder?
 *
Are there restrictions on who can be seen at your clinic? For example, some clinics only serve county residents, tribally enrolled people or pregnant people.
What’s the best way to request an urgent appointment for opioid use disorder (OUD) treatment during business hours (phone number, webform, etc.)? *
What’s the best way to request an urgent appointment for OUD treatment after hours/on weekends or on holidays (phone number, webform, etc.)? *
Do you prescribe sublingual buprenorphine (Suboxone/Subutex/Zubsolv)?
 *
Do you administer subcutaneous buprenorphine (Sublocade, Brixadi)?
 *
Do you prescribe intramuscular naltrexone (Vivitrol)?
 *
Do you dispense methadone for opioid use disorder?
 *
Do you provide primary care? *
Do you treat pregnant patients with opioid use disorder?
 *
Do you provide obstetric care?
 *
Do you treat hepatitis C?
 *
Do you prescribe buprenorphine for patients aged 16-17? *
Do you prescribe buprenorphine for patients aged 13-15? *
What on-site counseling or therapy resources do you have?
What are your office hours?
Do you accept Medicaid/BadgerCare?
 *
Do you have a sliding scale/discounted care for uninsured patients?
 *
Do you allow children to come to appointments?
Clear selection
Do you have on-site childcare?
Clear selection
Do you offer in-person visits, telemedicine visits or both?
Clear selection
Do you treat patients who are still actively using their drug of choice or other illegal substances? *
Any other information that’s specific for your clinic? For example, some prescribers have a dose limit for buprenorphine or won’t prescribe buprenorphine if someone is using other recreational drugs.
What health system is your clinic affiliated with (if any)?
What is the Application / Intake Process?
What documents are required?
What languages are supported other than English?
Bus Route
What is the Fee Structure for the Service?
What is the Method of Payment?
Payment Options?
Are there any gender restrictions for service?
What ages are the service available to? 
Who is prescribing buprenorphine at your clinic (name, profession (MD,DO,PA-C,etc.), specialty)? This information will not be shared.
Who is the best contact person for your clinic/organization (name, title, email, phone)? This information will not be shared. *
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