Medication Destruction Form. Prescription drugs not taken with the client/resident upon termination of services or otherwise disposed of shall be destroyed in the facility by the administrator or designated representative and witnessed by one other adult who is not a client/resident. Fill out the necessary fields (they are marked in.
DCO2
The information collected on this form is necessary for dea registrants to record controlled substances destroyed in accordance with the controlled substances act (csa). Web the best way to dispose of most types * of unused or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program. _____________________ date name of medication and dosage quantity destroyed method of destruction *see below medication discontinued by prescriber (yes or no) medication out of date (yes or no) initial # 1 initial # 2 name (print) / signature initials name (print) / signature initials You may use this form or create your own 1 Choose the document template you need from our collection of legal form samples. Apd 0800 (rev 11/17) you can get this document in large print, braille or a format you prefer. Pharmaceutical companies and distributors use this free medication disposal form template to collect information on expired, recalled, and excess medications and dispose of them in a safe and secure manner. A typed, drawn or uploaded signature. Web medication destruction record client: Fill out the necessary fields (they are marked in.
Choose the document template you need from our collection of legal form samples. Choose the document template you need from our collection of legal form samples. Select the document you want to sign and click upload. _____________________ date name of medication and dosage quantity destroyed method of destruction *see below medication discontinued by prescriber (yes or no) medication out of date (yes or no) initial # 1 initial # 2 name (print) / signature initials name (print) / signature initials Decide on what kind of signature to create. Place all other transdermal patches in a sturdy container and properly dispose of in the garbage. Web this form must be kept as a record of destruction and be available by the registrant for at least two years in accordance with 21 u.s.c. Web fill out medication destruction form in a few moments by simply following the instructions below: Web flush fentanyl patches down the toilet. Prescription drugs not taken with the client/resident upon termination of services or otherwise disposed of shall be destroyed in the facility by the administrator or designated representative and witnessed by one other adult who is not a client/resident. You may use this form or create your own 1
