Medication Order Packaging Checklist
Checklist for verifying and documenting correct packaging of medication orders before release.
Order Number
*
Patient Full Name
*
Medication Name
*
Medication Strength (e.g., 500 mg)
*
Medication Form
*
Please Select
Tablet
Capsule
Liquid
Injection
Topical
Other
Quantity to Dispense
*
Expiry Date of Medication
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Is the medication label correct and legible?
*
Yes
No
Requires Correction
Is the packaging intact and appropriate?
*
Yes
No
Requires Correction
Patient and order information matched and verified?
*
Yes
No
Requires Correction
Final review completed by
*
Date and time of completion
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Additional comments or notes
Complete Checklist
Should be Empty: