Regional Controlled Substance Kit Exchange Form 2026

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  1. Click ‘Get Form’ to open the Regional Controlled Substance Kit Exchange Form in the editor.
  2. Begin by entering the CSK Number at the top of the form. This is essential for tracking purposes.
  3. In the medication section, fill out the 'Amount Ordered' and 'Amount Given' for each listed medication, ensuring accuracy to maintain proper inventory records.
  4. Under 'Medications Administered', print the name of the provider administering the medications and include their unit number.
  5. Complete the 'Reason for Replacement' section by checking off any applicable reasons such as patient care or breakage.
  6. Ensure all signatures are collected from EMS attendants, accepting medical personnel, and waste witnesses before finalizing the form.

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