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ORDER FORM 1001 N. Hawks Perch Ave., Bldg. A Nixa, MO 65714FAX, MAIL, OR EMAILPhone: 4175873340 Fax: 4174433574 Email: aware@nartec.com Web: www.nartec.comBILL TO: (Please Print)SHIP TO: (Please Print)Agency___Agency:___Street
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How to fill out crush-ampule

01
Check and confirm the correct dosage of the medication to be crushed.
02
Place the crush-ampule on a flat surface.
03
Insert the medication into the crush-ampule.
04
Hold the crush-ampule firmly and twist the top part in a clockwise motion to crush the medication.
05
Once the medication is crushed to the desired consistency, remove the top part of the crush-ampule and pour the crushed medication into a suitable container for administration.

Who needs crush-ampule?

01
Patients who have difficulty swallowing whole pills or tablets.
02
Healthcare professionals who need to administer medication in a different form for specific patients.
03
Caregivers who assist patients in taking their medication.
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Crush-ampule is a form used to report the crushing of medication ampules.
Healthcare professionals or facilities that crush medication ampules are required to file crush-ampule.
To fill out crush-ampule, you need to provide information about the medication ampule being crushed, the reason for crushing it, and any precautions taken.
The purpose of crush-ampule is to ensure that medication ampules are crushed safely and appropriately.
Information such as the name of the medication ampule, its dosage, the reason for crushing it, and any precautions taken must be reported on crush-ampule.
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