On Call Documentation
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Pharmacy Services On-call Documentation
1.
Enter the name of the caller
*
2.
Enter pager number or call back number of the caller
3.
Please provide a brief description of the question asked or request
*
4.
Select your call assignment
*
-- Please Select --
AcuDose Service
Distribution Center
Hazardous Medication
High Cost Second Level Review
Investigational Drug Service
Nuclear Pharmacy
Operating Room
Pharmacy Administrator
5.
Enter the day you were paged
*
mm/dd/yyyy
6.
Enter the time you were paged (military - hhmm)
*
7.
How long did it take you to answer the question or resolve the issue?
*
8.
Did the on-call question require you to come to the hospital?
*
-- Please Select --
Yes
No
9.
If you had to return to the hospital, approximately how long were you at the hospital?
10.
Enter your firstname
*
11.
Enter your lastname
*
Thank you for documenting this on-call request!
