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Quarterly Pharmacy Naloxone Dispensing Report For Naloxone Inpatient Specific Prescription and Dispensing Protocol REPORTING PERIOD (ONE PER REPORT) January 1 March 31 April 1 June 30 July 1 September
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How to fill out non-patient specific prescription for

01
Obtain a blank prescription pad or template from a pharmacy or medical supply store.
02
Fill in the name and contact information of the prescriber at the top of the prescription.
03
Specify the date the prescription was written.
04
Write the name of the medication being prescribed in clear, legible handwriting.
05
Include the strength and dosage instructions for the medication.
06
Indicate the quantity of the medication being prescribed.
07
Sign the prescription with your full name and any relevant credentials.
08
Provide any necessary refill instructions or expiration date for the prescription.
09
Keep a copy of the completed prescription for your records.

Who needs non-patient specific prescription for?

01
Healthcare providers who are prescribing medications to be administered by a caregiver.
02
Pharmacists who are dispensing medications for use in a healthcare facility or for emergency situations.
03
Employers who are providing medications for first aid kits or workplace safety protocols.
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Non-patient specific prescriptions are for medications that are not tied to a specific patient but are used for general purposes.
Healthcare providers such as doctors, nurse practitioners, or pharmacists may be required to file non-patient specific prescriptions.
Non-patient specific prescriptions can be filled out by indicating the medication, dosage, and instructions for use without specifying a particular patient.
The purpose of non-patient specific prescriptions is to ensure that healthcare providers have access to medications for general use without needing to write individual prescriptions for each patient.
Information such as the name of the medication, dosage, administration route, and any special instructions must be reported on non-patient specific prescriptions.
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