A therapy management contract shall be signed by the: Authorized prescriber or authorized prescribers involved in the management of the patient under a prescriber-pharmacist agreement; Pharmacist or pharmacists involved in the management of the patient under a prescriber-pharmacist agreement; and Patient receiving care under the therapy management contract. A therapy management contract shall contain: A list of allowable substitutions of chemically dissimilar drugs, if any; A statement that: None of the parties involved in the therapy management contract have been: Coerced into participating in the therapy management contract; Given economic incentives, excluding normal reimbursement for services rendered; or Involuntarily required to participate in the therapy management contract; and The pharmacist shall notify the authorized prescriber under the terms of the prescriber-pharmacist agreement if the pharmacist: Modifies the dose or agent under the therapy management contract; or Detects an abnormal result from an assessment activity; Notice to the patient stating: That the patient may terminate the therapy management contract at any time; and The procedure by which the patient may terminate the therapy management contract; A procedure for periodic review by the authorized prescriber of the drugs modified under the prescriber-pharmacist agreement or changed with the consent of the authorized prescriber; A reference to the protocol or protocols under which the pharmacist shall act; and Exceptions or limitations to the protocol or protocols for the specific patient.