Guest Dosing
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Guest Dosing Services and Information
To Arrange Guest Dosing Services please send:
Signed Consent.
Proposed Guest Dose Schedule.
30-day dosing history.
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Access to licensed treatment centers
Information on treatment plans
Financial assistance options
Cost of Treatment Services:
One-Time Registration Fee: Call for details
Silverman Treatment Solutions accepts cash, Visa, MasterCard, and Discover, as well as money orders.
Please note that personal checks are not accepted.
Identifying Information to Be Included in the Fax Request From Home Clinic:
Patient’s full name
Social Security Number
Driver License Number or State ID Card Number
Date of Birth
Dosing Level / Medical Status
Phase Level & Dosing Schedule
Last 3 drug tests
Dates of guest dosing
Silverman Treatment Solutions Welcomes Patients Visiting the Area and in Need of Guest Dosing Services.
Visiting patients will find our professional and patient-centered facilities easy to access, and we strive to provide excellent patient care.
In preparation for guest dosing, each patient’s home clinic will need to contact us via phone/fax prior to arrival at Silverman Treatment.
Each patient’s home clinic MUST fax a signed copy of a guest dosing request form, including the signature of the Medical Director.
A minimum of 24 hours-notice must be given from home clinic. If guest dosing is to start on Saturday, all information should be received by noon Friday.
A metal lock-box is required if eligible for take home medication.
Any take home medication must be specified by your home clinic.