Individual Records. Pharmacy must maintain an individual record of administration including: individual name, date, address of administration, vaccine administered,
Appears in 6 contracts
Samples: Non Patient Specific Order, Non Patient Specific Order, Non Patient Specific Order
Individual Records. Pharmacy must maintain an individual record of administration including: individual individual’s name, address, telephone number, date of birth, allergies and gender; vaccine administered, the manufacturer, expiration date, address lot number, site of administration, vaccine and dose administered,; date of original order and the date of administration(s); name and address of Authorizing physician, and the name and address of Pharmacist administering the dose, and
Appears in 6 contracts
Samples: Standing Order for Pharmacist Administered Vaccines, Standing Order for Pharmacist Administered Vaccines, Standing Order for Pharmacist Administered Vaccines
Individual Records. Pharmacy must maintain an individual record of administration including: individual name, date, address vaccine given, manufacturer, lot number, expiration date, and signature of administration, vaccine administered,person administering vaccine.
Appears in 6 contracts
Samples: Collaborative Agreement, Pharmaceutical Care Agreement, Collaborative Pharmacy Practice Agreement
Individual Records. Pharmacy must maintain an individual record of administration including: individual individual’s name, address, telephone number, date of birth, allergies and gender; vaccine administered, the manufacturer, expiration date, address lot number, site of administration, vaccine administered,and
Appears in 1 contract
Samples: Standing Order for Pharmacist Administered Vaccines
Individual Records. Pharmacy must maintain an individual record of administration including: individual individual’s name, datedate of birth, and address; date vaccine administered and site of injection; name, dose, manufacturer, lot number, and beyond use date of the vaccine; name and address of administration, the individual’s primary health care provider named by the individual; name or unique identifier of Pharmacist; and which vaccine administered,information statement (VIS) was provided.
Appears in 1 contract
Samples: Standing Order for Pharmacist Administered Vaccines
Individual Records. Pharmacy Pharmacist must maintain an individual record of administration including: individual name, date, address vaccine given, manufacturer, lot number, expiration date, signature of administrationperson administering vaccine, vaccine administered,and the informed consent form on file at the pharmacy.
Appears in 1 contract
Samples: Collaborative Drug Therapy Agreement
Individual Records. Pharmacy must maintain an individual record of administration including: individual name, dateaddress, date of birth; date of administration and site of injection; name, dose, manufacturer, lot number, and expiration date of vaccine; name and address of administrationindividual’s primary care provider, vaccine administered,as identified by individual; and name or identifiable initials of Pharmacist or intern, if applicable.9
Appears in 1 contract
Individual Records. Pharmacy must maintain an individual record of administration including: individual name, date, address vaccine given, manufacturer, lot number, expiration date, and signature of administration, vaccine administered,person administering vaccine. Pharmacy must provide Authorizing Practitioner with each individual record created under this Agreement.4
Appears in 1 contract
Samples: Collaborative Agreement
Individual Records. Pharmacy must maintain ensure that an individual record of administration is maintained including: individual name, date, address vaccine given, manufacturer, lot number, expiration date, and signature of administration, vaccine administered,person administering vaccine.
Appears in 1 contract
Samples: Collaborative Agreement
Individual Records. Pharmacy must maintain an individual record of administration including: individual name, date, address of administration, vaccine administered,, manufacturer, lot
Appears in 1 contract
Samples: Non Patient Specific Order
Individual Records. Pharmacy must maintain an individual record of administration including: individual name, date, address vaccine given, manufacturer, lot number, expiration date, and name and signature of administration, vaccine administered,person administering vaccine.
Appears in 1 contract
Samples: Collaborative Agreement
Individual Records. Pharmacy must maintain an individual record of administration including: individual name, date, address vaccine given, manufacturer, lot number, expiration date, and signature of person administering vaccine. In addition, Pharmacy must provide the individual with a written certificate of administration, vaccine administered,or make an entry of the immunization on a certificate in the person’s possession.1
Appears in 1 contract
Samples: Collaborative Agreement