§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.