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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*SUBSCRIPTION: Form access is licensed for 1-year per agency/facility location. Multiple sites require a quote. 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 (please allow 2-3 business days for order fulfillment) and provide the facility/agency address. After 1- year, your subscription will automatically renew.
All Briggs Digital on Demand products require a credit card payment (or pre-payment) to receive digital files electronically.
Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees.