Dds Medication Log In Sheet
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2995 Worthington Street, Springfield, MA 01109
Telephone 413-734-5376 FAX 413-737-7949
DDS Medication Log I n
Sheet
Medication Tracking Sheet for: ______________________________________
Program: _______________________
Instructions:
1. Check new pills versus old pills (if available) for size and color. Due to generics pill shapes and colors may change frequently, if they
appear different call pharmacy for verification and notify supervisor as well as document.
2. Check Pharmacy Label versus Doctor’s Order & MARs – If there is a discrepancy please notify supervisor/nursing
Verified Pharmacy
Supervisor
Dose /
# Of
Amount
Label to Doctor’s
Date
RX #
Medication / Strength
or Nursing
Staff Signature
Rec’d
Frequency
Refills
Order & MARs?
Notified?
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Parent category: Medical