(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.
Author: Alabama Board of Medical Examiners
Statutory Authority: Code of Ala. 1975, §20-2-60, et. seq.; Act 2009-489.
History: New Rule: Published December 30, 2022; effective
February 13, 2023.