Clinic Report
Please include as many details as possible. Reports received will be posted to the Watchdog web site at http://www.atwatchdog.org. An online form is available on the Watchdog site. Please mail to:
PO BOX 585
Springfield, MO 65801
Your Name
Your Address
Your City and State
Clinic Name
Clinic Street Address, City and State
How long have you attended this clinic?
What is the weekly fee?
Is clinic privately owned?
Is there a waiting list?
Is there a dose cap?
Is group counseling mandatory?
Is an emergency plan in effect?
Is staff on call at ALL times?
Does clinic have observed UA policy?
Does clinic offer Hep C testing or referral?
Does your clinic offer diskettes as well as liquid methadone?
Does clinic require takehomes bottles to be returned?
Does clinic have a call-back policy?
Does clinic allow 14 day takehomes?
Does clinic allow 27-31 day (monthly) takehomes?
Briefly state your complaint. Please give information about your clinic that a new patient would find useful, or policies that you find to be exceptionally abusive or humiliating.