(A) The written consent agreement required under division­(F)­(2) of section 4730.25 of the Revised Code, division (B)(26) of section 4731.22 of the Revised Code, division (F)(2) of section 4760.13 of the Revised Code or division (F)(2) of section 4762.13 of the Revised Code and rule 4731-16-02 of the Administrative Code prior to reinstatement of a suspended license, or any board order entered in lieu of a consent agreement, shall require, at a minimum, the following probationary and limiting terms:

(1) Obedience of all federal, state, and local laws, and all rules governing practice in Ohio;

(2) Submission of quarterly declarations under penalty of perjury stating whether there has been compliance with all conditions of the consent agreement;­

(3) Periodic appearances before the board or its representatives as requested;

(4) Permission from­ the board for departures or absences­from Ohio. Such periods of absence shall not reduce the probationary term, unless otherwise determined by motion of the board for absences of three months or longer, or by the secretary or the supervising member of the board for absences of less than three months, in instances where the board can be assured that probationary monitoring is otherwise being performed;

(5) Restriction, surrender, or suspension of the practitioner's U.S. drug enforcement administration certificate, where appropriate;­

(6) Maintenance of a log of all controlled substances, and other drugs as directed by the board, which the practitioner prescribes, dispenses, or administers, where appropriate;­

(7) Prohibition of authority to prescribe, administer, dispense, order, or possess controlled substances and other substances which may impair ability to practice, where appropriate;­

(8) Abstinence from the use of alcohol;­

(9) Abstinence from the use or personal possession of drugs, except those prescribed, administered, or dispensed by another person so authorized by law who has knowledge of the patient's history and disease of addiction;­

(10) Submission of witnessed urine or blood samples upon request of the board, and without prior notice;­

(11) Undertaking and maintaining participation in alcoholics anonymous, narcotics anonymous or other self help support group acceptable to the board, where appropriate, in accordance with the terms of the aftercare contract entered into with the approved treatment provider, with evidence of compliance to be provided to the board in each quarterly report;­

(12) Undertaking psychiatric evaluation, and, where appropriate, continuing treatment acceptable to the board, with evidence of compliance to be provided in each quarterly report; and

(13) Monitoring of progress and status by a physician approved by the board, with reports to be provided to the board quarterly;­

(14) Prior approval by the board of any practice arrangements or any health care field employment, where appropriate;

(15) Copies of the agreement to be provided by the individual to all current or prospective employers and hospital chiefs of staff, and to all persons and entities that provide the individual chemical dependency treatment or monitoring;

(16) Contacting the appropriate impaired physicians committee, such as the physician effectiveness program, to arrange for assistance in recovery or aftercare;

(17) Continuing compliance with the terms of the aftercare contract entered into with the treatment provider, provided, that where terms of the aftercare contract conflict with the terms of consent agreement, the terms of the consent agreement shall control;

(18) Continuing authorization, through appropriate written consent forms, for disclosure by the treatment provider to the board, to treating and monitoring physicians, and to others involved in the monitoring process, of information necessary for them to fulfill their respective duties and obligations;

(19) Minimum probationary term of at least five years, except that a practitioner who first applies for licensure or license restoration after receiving treatment for impairment may be given probation of less than five years if the practitioner demonstrates continuous current sobriety of more than one year but less than five years, and a practitioner who first applies for licensure or license restoration after receiving treatment for impairment may be licensed without probation if the practitioner demonstrates continuous current sobriety of at least five years;

(20) Periods during which the probationer is not in compliance with all probationary terms, or during which all probationary monitoring provisions have not yet been implemented, as determined by the secretary of the board, shall not reduce the term of probation;

(21) No requests by the probationer for modifications to probationary terms for at least one year; and

(22) Prohibition of consumption of poppy seeds or any other food or liquid

(B) A violation of any term of the consent agreement described in this rule shall constitute grounds to take disciplinary action in accordance with Chapter 119. of the Revised Code.

Effective: November 30, 2002