CENTRALLY STORED MEDICATION AND DESTRUCTION RECORD 2026

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Facility Name' and 'Facility Number' at the top of the form. Ensure that these details are accurate as they identify your facility.
In the 'Centrally Stored Medication' section, fill in each client's name (last, first, middle) along with their medication details including 'Medication Name', 'Strength/Quantity', and 'Expiration Date'.
Record important dates such as 'Admission Date', 'Date Filled', and 'Date Started'. This helps maintain a clear timeline for medication management.
Complete the information for both prescribing and attending physicians, including their names and prescription numbers. This ensures proper tracking of medications.
For the 'Medication Destruction Record', document any medications disposed of, including their names, strengths, and disposal dates. Ensure signatures from both the Administrator and a witness are included.

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