Wash. Admin. Code § 246-978-020 - Reporting

(1) To comply with the act, within 30 calendar days of writing a prescription for medication to end the life of a qualified patient, the attending qualified medical provider shall send the following completed documents to the department electronically, by mail, or fax:

(a) The patient's written request for medication to end life, either using the Written Request for Medication to End My Life in a Humane and Dignified Manner form or in substantially the same form as described in the act;

(b) Attending qualified medical provider's compliance form;

(c) Consulting qualified medical provider's compliance form; and

(d) Psychiatric/psychological consultant's compliance form, if an evaluation was performed.

(2) Within 30 calendar days of a qualified patient's ingestion of a lethal dose of medication obtained under the act, or death from any other cause, whichever comes first, the attending qualified medical provider shall send the completed attending qualified medical provider's after death reporting form to the department electronically, by mail, or fax.

(3) To comply with the act, within 30 calendar days of dispensing medication, the dispensing health care provider shall send a copy of the pharmacy dispensing record form to the department electronically, by mail, or fax. The pharmacy dispensing record form must contain:

(a) Patient's name and date of birth;

(b) Patient's address;

(c) Prescribing qualified medical provider's name and phone number;

(d) Dispensing health care provider's name, address and phone number;

(e) Medication dispensed and quantity;

(f) Date the prescription was written; and

(g) Date the medication was dispensed.

Notes

Wash. Admin. Code § 246-978-020

Amended by WSR 23-17-071, Filed 8/14/2023, effective 9/14/2023

Statutory Authority: Chapter 70.245 RCW. 09-06-010, § 246-978-020, filed 2/20/09, effective 3/5/09.