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State of Utah Division of Occupational & Professional Licensing 160 East 300 South, P.O. Box 146741 Salt Lake City, Utah 841146741 Telephone (801) 5306628 www.dopl.utah.govPHYSICIAN ASSISTANT ($180.00
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How to fill out controlled substance 100

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To fill out Controlled Substance 100 form, follow these steps:
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Start by entering the date of the form in the designated field.
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Provide your name and contact information as the prescriber.
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Include the patient's name, address, and date of birth.
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Specify the medication being prescribed and its dosage instructions.
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Indicate the quantity of the prescribed medication.
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Include any additional information or special instructions as necessary.
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Sign and date the form to certify the prescription.
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Keep a copy of the form for your records and provide the original to the appropriate authority or pharmacy.

Who needs controlled substance 100?

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Controlled Substance 100 is required by healthcare professionals, specifically prescribers, who are prescribing a controlled substance to a patient. This form helps ensure proper documentation and tracking of prescription drugs for regulatory purposes.

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Controlled substance 100 is a form used to report the inventory of controlled substances in a healthcare facility.
Healthcare facilities and pharmacies are required to file controlled substance 100.
Controlled substance 100 should be filled out by documenting the quantities of controlled substances on hand and submitting the form to the appropriate regulatory agency.
The purpose of controlled substance 100 is to track and monitor the inventory of controlled substances in healthcare facilities and pharmacies.
Controlled substance 100 requires reporting the name, quantity, and location of each controlled substance in the inventory.
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