Psychotropic Medication Informed Consent; 2-Part
UPDATED 2023
Briggs Psychotropic Medication Consent form provides the resident/resident representative with the required (F552, F605 & F758) information to provide informed consent for the use of psychotropic medications. The form provides for documentation of:
• | Medical diagnosis for use of psychotropic medication; also specific purpose for use |
| • | Non-pharmacological interventions that have been used and found to be ineffective |
| • | Proposed course/length of duration for the use of the psychotropic medication |
| • | Behaviors exhibited that would benefit from medication |
| • | Consent and acknowledgment of black-box warnings reviewed with the resident/resident representative |
| • | Declination of consent |
• Size: 8 ½” x 11”
• Two-Part Form: Part 1: White, Part 2: Pink
• Prints one-side; black ink
• 5-hole punched top and side
• 100 per pack