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5 mg Tablet Quantity or Liquid Amount Reason for Disposal/ Destruction Source of Controlled Substance Rx Number Class 3A license holders only Discontinued Smith Pharmacy 1234567 Page of DOH-166 7/10 Page 1 of 1.
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How to fill out controlled substance inventory form?

01
Begin by gathering all the necessary information and documents required to complete the form. This may include the name of the controlled substances, their quantities, and any related information such as lot numbers or expiration dates.
02
Follow the instructions provided on the form carefully. These instructions will guide you on how to accurately fill in the required fields and sections of the form.
03
Ensure that all the information you provide is accurate and up to date. Any discrepancies or errors may lead to complications or legal consequences.
04
Double-check your completed form for any missing or incomplete information. It is crucial to ensure that all the necessary information has been accurately recorded.
05
Once the form is completed, review it one final time to ensure its accuracy and completeness. Make sure that all sections are filled out properly and that there are no errors or omissions.
06
Submit the controlled substance inventory form to the appropriate authority or department as instructed. Follow any additional guidelines or procedures provided, such as sending a copy to a specific location or individual.

Who needs controlled substance inventory form?

01
Healthcare professionals, such as doctors, nurses, or pharmacists, who handle and administer controlled substances in a clinical setting need the controlled substance inventory form.
02
Pharmacies or other healthcare facilities that store and dispense controlled substances are required to maintain accurate inventory records using the controlled substance inventory form.
03
Research institutions or laboratories that use controlled substances for scientific or medical research purposes should also complete the controlled substance inventory form to track and document their inventory.
04
Government agencies or regulatory bodies may require controlled substance inventory forms as part of auditing or monitoring processes to ensure compliance with relevant laws and regulations.
05
Any individual or entity authorized to handle controlled substances, such as manufacturers or wholesalers, may also need to use the controlled substance inventory form to keep track of their inventory and provide necessary documentation when requested.
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The controlled substance inventory form is a document used to record the quantities of controlled substances held by a facility or individual. It helps ensure compliance with regulations governing the storage, distribution, and use of these substances.
Individuals or entities such as pharmacies, hospitals, and healthcare providers that handle controlled substances are required to file a controlled substance inventory form. This includes any facility that manufactures, distributes, or dispenses these substances.
To fill out the controlled substance inventory form, one must provide details including the date of the inventory, the name and strength of each controlled substance, the quantity on hand, and the name of the person conducting the inventory. It's important to ensure accurate and complete reporting.
The purpose of the controlled substance inventory form is to maintain an accurate record of all controlled substances in possession, to monitor compliance with legal requirements, and to prevent misuse or diversion of these substances.
The information that must be reported includes the date of the inventory, the name and dosage form of the controlled substance, the total quantity in stock, the name and signature of the individual completing the inventory, and any discrepancies noted during the process.
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