Psychotropic Medication Therapy Informed Consent
Updated 2025
Revised and reviewed for alignment with revisions to Appendix PP, effective April 28, 2025.
Form 3681-2P provides for informed consent to administer psychoactive medications, including areas for explanation of conditions being treated as well as the expected benefits and possible side effects.
The reverse side of the form identifies psychotropic medications commonly used (brand + generic names) as well as additional resources for clinicians.
- 2-Part Carbonless form
- White/Canary paper, black ink
- 5-hole punch top and side
- 100 per pack