Farm Medication Audit Form
Record and review medication use, compliance, and storage practices on your farm.
Medication Name
*
Batch or Lot Number
*
Date of Administration
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Animal(s) Treated
*
Dosage Administered (include units)
*
Reason for Medication Use
*
Please Select
Disease treatment
Disease prevention
Routine health protocol
Other
Person Administering Medication
*
Is medication stored according to label instructions?
*
Yes
No
Partially
Are records up-to-date and compliant?
*
Yes
No
Partially
Auditor Observations and Comments
Submit Audit
Should be Empty: