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MEDICAL QUESTIONNAIRE ON WITHDRAWAL
OF OPIATES UNDER ANAESTHESIA
Are you dependent on opiates and interested in the opiate withdrawal procedure under anaesthesia that we offer at Interlaken Hospital? To find out whether you are suitable for the OPIOSTOP procedure, please answer the following questions truthfully. Please do not conceal anything – we need to be able to make a realistic assessment of your situation.
The questionnaire will be treated with the utmost confidentiality, and all parties involved are bound by professional confidentiality. You can contact us at any time to obtain information about the procedure without any obligation whatsoever, regardless of whether you have completed the questionnaire.
On behalf of the treatment team, we would like to thank you for the confidence you have placed in us and will contact you as soon as possible.