77 Ill. Adm. Code 2085.EXHIBIT D
D Special Instructions Covering Research Medication Labels for Delta-9-Tetrahydrocannabinol Containers
Section 2085
Section 2085.EXHIBIT D
Special Instructions Covering Research Medication Labels for
Delta-9-Tetrahydrocannabinol Containers
SPECIAL INSTRUCTIONS
COVERING RESEARCH MEDICATION
LABELS FOR
DELTA-9-TETRAHYDROCANNABINOL CONTAINERS
HOSPITAL PHARMACY
1234 MAIN STREET
ANYWHERE, ILLINOIS
DEA NO. XX 0000000
PHONE NO. ( ) 000-0000
RO NO:
123-456
PHYSICIAN:
JOHN DOE
DATE: 10-10-80
ONE CAPSULE EVERY SIX HOURS AS NEEDED.
DELTA-9-THC
5MG (#25)
VALID FROM 10-10-80 to 10-20-80
(RPH INITIALS)
CAUTION: FEDERAL LAW PROHIBITS
THE
TRANSFER OF THIS DRUG TO ANY
PERSON
OTHER THAN THE PATIENT FOR WHOM
IT
WAS PRESCRIBED.
THIS PRESCRIPTION CANNOT BE
REFILLED
RETURN UNUSED PORTION TO
DISPENSING
PHARMACY FOR PROPER DISPOSAL.
KEEP OUT OF REACH OF CHILDREN.
IN CASE
OF ACCIDENTAL OVERDOSE, CONTACT
A
PHYSICIAN IMMEDIATELY.