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MED-PASS:  The Fine Art of Document Design

Medication Regimen Review Request Notification - 100/pad


Availability: In stock

Price: $12.50
  • Buy 5-9 for $9.70 each and save 23%
  • Buy 10 or more for $8.90 each and save 29%

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Changes to the SOM (Surveyor Guidelines for F-425 and F-428) have placed greater surveyor focus on the consultant pharmacists medication regimen review (MRR) requirements. With new emphasis on MRRs for “short stay” residents and “significant changes in resident status”, one of the challenges to the consultant pharmacist is being made aware of when there is need for an interim MRR.

Facility staff can use this form to fax an MRR request to the consultant pharmacist. A convenient checklist documents clinical needs and therfore prompts staff to send supporting documentation such as hospital discharge records. A barcode for electronic document management has been added.

  • Convenient minimum order quantities of 100 per pad
  • Pre-punched 5 holes top and side for standard facility charts and binders
  • Routing bar code added for electronic document management utilizing the Integra DocuTrack system
  • Can be customized with pharmacy name, logo, fax number, etc. - contact MED-PASS customer service for details
Size 8-1/2 x 11
Unit Pad of 100
Other Info Handwritten
Hole Punch 5 holes left, 5 holes top

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