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  • Contract For Use Of Controlled Substance Prescriptions

Get Contract For Use Of Controlled Substance Prescriptions

Lacey Medical Clinic 5602 Ruddell Rd SE Lacey, WA 98503 (360) 4380394 CONTRACT FOR USE OF CONTROLLED SUBSTANCE PRESCRIPTIONS There are times when your Primary Care Provider (PCP) finds it necessary.

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This document is an agreement between patient and physician regarding the use of benzodiazepines, a class of medications that are used to treat a variety of conditions including anxiety, insomnia, muscle spasticity, convulsive disorders, as well as detoxification from alcohol and other substances.

Legally, the requisition form must: be signed by the doctor. state the prescriber's name, address and area of practice (e.g. GP) specify the total quantity of drug (the total quantity of drug does not have to be written in both words and figures) state the purpose of the requisition. (e.g. 'practice use')

Include on the form: the signature and printed name of the person ordering the controlled drug. the name of the care setting. the ward, department or location. the controlled drug name, form, strength, and for ampoules, the size if more than 1 is available. the total quantity of the controlled drug to be supplied.

Requirements for a controlled drug prescription Be indelible. Be dated. Be signed by the prescriber. Include the prescriber's address. Include the name and address of the patient. Include the date of birth of the patient (and age if <12 years)

Controlled drugs (CDs) can be prescribed to a patient on either an NHS prescription form or a private prescription form.

Prescriptions for Controlled Drugs that are subject to prescription requirements (all preparations in Schedules 2 and 3) must be indelible, must be signed by the prescriber, include the date on which they were signed, and specify the prescriber's address (must be within the UK).

FP10 prescriptions are purchased by NHS organisations including Hospital Trusts, and are distributed free of charge to medical and non medical prescribers, NHS dentists and other organisations as required.

Prescription requirements State the name and address of the patient. Be written or printed legibly in ink. Be signed in indelible ink. Have an appropriate date (usually the date of signing) State the address of the prescriber. State the age of a child under 12.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232