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2829 University Ave SE, Suite 530 Minneapolis, MN 55414 Phone: 651/201-2836 Fax: 651/201-2837 www.pmp.pharmacy.state.mn.us Controlled Substance Prescription History Request Form (Law Enforcement Request)

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What is controlled substance prescription history?

Controlled substance prescription history refers to a record of prescriptions for medications classified as controlled substances, which are drugs with a high potential for abuse and dependence. This history includes information about the prescribing healthcare professional, the patient, and the medication prescribed.

Who is required to file controlled substance prescription history?

Healthcare professionals, such as physicians, nurses, and pharmacists, who prescribe or dispense controlled substances are required to file controlled substance prescription history. They must report this information to the appropriate regulatory body or government agency as per the regulations in their jurisdiction.

How to fill out controlled substance prescription history?

To fill out a controlled substance prescription history, healthcare professionals need to maintain accurate records of the controlled substances they prescribe or dispense. They should include information such as the patient's name, date of prescription, medication details, dosage, and prescribing healthcare professional's information. These records can often be submitted electronically through designated reporting systems.

What is the purpose of controlled substance prescription history?

The purpose of controlled substance prescription history is to monitor and track the prescribing and dispensing of controlled substances. It helps identify patterns of potential misuse, over-prescribing, and diversion of these medications. The history also aids in patient safety by providing a comprehensive record of their controlled substance prescriptions, allowing healthcare professionals to better manage and coordinate their care.

What information must be reported on controlled substance prescription history?

The information that must be reported on controlled substance prescription history includes the patient's name, date of prescription, medication details (including dosage and quantity), the prescribing healthcare professional's information (such as name, license number, and contact details), and the pharmacy or healthcare facility where the prescription was dispensed.

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