Ala. Admin. Code r. 540-X-12-.07.01 - Prescription Guidelines - Qualified Alabama Controlled Substances Registration Certificate (QACSC)

(1) When prescribing controlled substances, a P.A. shall use a prescription form which includes all of the following:

(a) The name, medical practice site address and telephone number of the supervising physician.

(b) The name of the P.A.

(c) The medical practice site address and telephone number of the P.A. if different from that of the supervising physician.

(d) The P.A.'s license number.

(e) The words "Product Selection Permitted" printed on one side of the prescription form directly beneath a signature line.

(f) The words "Dispense as written" printed on one side of the prescription form directly beneath a signature line.

(g) The date that the prescription is issued to the patient.

(h) The patient's full name and address.

(i) The P.A.'s QACSC registration number.

Notes

Ala. Admin. Code r. 540-X-12-.07.01

Adopted by Alabama Administrative Monthly Volume XLI, Issue No. 03, December 30, 2022, eff. 2/13/2023.

Authors: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, 20-2-60, et. seq.; Act 2009-489.