Get Physicians Instruction To Use A Medicine To Be Extemporaneously Prepared

This guide provides a comprehensive overview of the form 'Physicians Instruction To Use A Medicine To Be Extemporaneously Prepared.' Follow these instructions to ensure that you complete the form accurately and efficiently for clinical use.

Follow the steps to effectively fill out the form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Identify the name of the hospital or clinic where the medication will be used. Enter the appropriate name in the designated field.
3. In the 'Ward / Department' section, specify the relevant ward or department responsible for the prescription.
4. Fill in the details regarding the composition of the medication, including the active ingredients and their quantities. Be precise when listing 'Troclosene Sodium' or any other specified substance and its proportions.
5. Indicate the pharmaceutical form and the number of units required. This includes stating whether it is in tablet form or a ready-to-use solution, alongside the required quantity.
6. Provide reasons and medical references for recommending the use of the extemporaneously prepared medicine in the section dedicated to justification. Explain why a registered product is not available.
7. Sign the physician's affirmation, confirming your responsibility for the prescription and the understanding that the medicinal substance is not registered. Fill in your name, license number, and date on this section.
8. Complete the pharmacist's section by providing the pharmacist's name and license number as required. Ensure that all details are accurate.
9. Once all sections are completed, review the form for accuracy and completeness before proceeding to save, download, print, or share it as needed.

Ensure your documents are correctly filled out and submitted online for efficient processing.