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- Begin by entering the person's name and ID number at the top of the form. This information is essential for identifying the patient.
- In the section regarding medications, list each medication along with its target symptoms. Ensure you specify symptoms rather than diagnoses for clarity.
- For each medication, indicate how it was discussed (e.g., in-person, telephone, telemedicine) by checking the appropriate boxes.
- Have the person or guardian provide their initials and date next to each medication listed, confirming their understanding and consent.
- The prescriber should also initial and date next to their respective entries, ensuring all parties are informed and in agreement.
- Finally, ensure that both signatures are obtained at the bottom of the form before saving or exporting your completed document.
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