Drug Disposal Sheet DHS 4590 6/09
|Drug Disposal Sheet |[pic] |
| |Stabilization and Crisis Unit |
House name: Reason for disposalMethod of disposalSignaturesDate
(mm/dd/yyyy)Client nameDrug description:
Why taken:DoseAmountDiscontinuedRecalledOutdatedUnusedOther: Disp. SolutionCat litterCoffee GroundsOther: DestroyerWitness
(RN if narcotic)
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