{"data":{"id":"us-in/ic-16-42-24-7","jurisdiction":"us-in","citation":"IC 16-42-24-7","heading":"Use request form","body":"Sec. 7. (a) The state department shall prepare a form for a patient to use to request administration of chymopapain. The form must be substantially in the following form:\nREQUEST FOR ADMINISTRATION OF\nCHYMOPAPAIN FOR MEDICAL\nTREATMENT\nPatient's name _______________________________\nAddress _____________________________________\nAge ___________ Sex ____________\nName and address of administering physician\n_____________________________________________\nPhysical condition diagnosed for medical treatment by chymopapain\n_____________________________________________\n_____________________________________________\nMy physician has explained the following to me:\n(1) That the manufacture and distribution of chymopapain has been banned by the federal Food and Drug Administration.\n(2) That there are alternative recognized treatments for the back ailment from which I suffer that my physician has offered to provide for me, including the following: (Here describe)\n____________________________________________\n____________________________________________\nNotwithstanding this explanation, I request the administration of chymopapain in the medical treatment of the back ailment from which I suffer.\n_______________________________________\nPatient or person signing for patient\nATTEST:\n______________________________________\nPrescribing physician\n(b) A copy of the request form shall be sent immediately after execution to the state department.","path":["TITLE 16. HEALTH","ARTICLE 42. REGULATION OF FOOD, DRUGS, AND COSMETICS","Chapter 24. Drugs: Use of Chymopapain"],"source_url":"https://iga.in.gov/ic/2026/Title_16.html#16-42-24-7","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-11T20:02:18Z","sha256":"85bc98a63a6ad9b83b845ecc493f7b7f0196def436b229c12345ee851a53cb01","source_id":"us-in","stale":false,"prev":"us-in/ic-16-42-24-6","next":"us-in/ic-16-42-24-8"},"notice":"GroundRules: Original legal text. Not legal advice."}