Physicians Telephone Order Audit 4-Part Form

Briggs Form 982 includes a check-off audit block.

The last part on this form serves as a temporary copy as well as the mount sheet once the signed original is returned. Routing is as follows:

·      ORIGINAL COPY-Physician Please Sign and Return

·       PHARMACY COPY-Send to Pharmacy

·       DATA ENTRY COPY

·       CHART CONTROL COPY-Attach Original Signed Copy When Received

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