Approved Formulary
Alabama Medicaid Formulary
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CHS Homepage
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Approved Formulary
Alabama Medicaid Formulary
Questions or Suggestions?
CHS Homepage
Forms

Alaris Forms

Black Bin Hazardous Waste Log

Clarification Order Form

Clinic Pharmacy Requisition Form

Diluted Insulin Grid

Emergency Cart.Bag.Kit Forms

Felbamate (Felbatol) Patient/Physician Acknowledgment Form (see page 4)

Formulary Forms

Home Medication “Identified for Patient Use” Log

Home Medication “Storage” Log

Insulin Safety Card

IV-Daily

IV-LOG 2

IV-LOG 4

LASA Request Form

Medications Received Log Sheet

Medication Replacement and Refill Request Form

Medication Safety Committee-Policy Subcommittee—Request for Policy Review

Medi-Dose Compound QA

Medi-Dose Powder Packet QA

Medi-Dose Wksht10

Medi-Dose-IVRecons

Pharmacy Machine/Application Downtime Algorithm

PO Report

PTO Form

Pyxis MedStation Access Change or Removal Request

Pyxis Override Request Form

Receipt of Tubed Meds form

RX Compounding Log

Shift Swap Agreement

Pharmacy Phone Numbers:
Inpatient Pharmacy: 205-638-9641
IV Room: 205-638-9716
Pharmacy Offices: 205-638-9718

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Use by pharmaceutical/medical representatives or non-CHS personnel is strictly prohibited.


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