Controlled Drug Administration Record Assisted Living - DIGITAL FORM
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Updated August 2023
Designed for use in an Assisted Living community to record the administration of controlled drugs per individual resident and the:
• | Name of drug, strength, dose, and form as well as directions for use of a controlled drug |
• | Dispensing pharmacy identification; receipt of drug |
• | Where stored |
• | Route of administration |
• | Recording of 30 doses |
• | Appropriate signatures |
• | Disposition of unused drug |
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*This digital form is delivered as a form-fillable PDF and includes 1-year of updates. To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery