ࡱ>  Root Entry F䘒ObjectPool˜˜WordDocument TK @Normala $@$ Heading 1]c&@"& Heading 2xU]c$@2$ Heading 3xUc">@"Title>]c0hOhOutline (Not Indented)@Kh 4h.cdOdOutline (Indented)@Lh 4h.c&O& Table Text Mc^O^ Number List@Nh 4h.c,O,First Line IndentOcZOZBullet 2@Ph 4hvcZOZBullet 1@Qh 4hc O" Body SingleRc O2 Default TextSc /[\  gTimes New Roman Symbol &Arial&Arial BlackWingdingsMS Sans Serif"!!Martin Bennettange pharmacies then we ask you to note that your records may be passed to the new pharmacy. We hope the scheme proves helpful to you. Can we point out that we have available various leaflets covering harm reduction and self-help groups. All pharmacies taking part in this scheme have facilities to accept for destruction, used syringes & needles, provided they are in small sized sharps containers, which we have available. Larger containers should be returned to the Rockingham Drugs Project on Rockingham Street. I have read the information above and have been provided with the leaflet entitled Instalment Prescriptions - The Rules. I give my consent to share my information in the manner described above. Signed Date PRINT NAME Co-ordinated Pharmacy Services for Drug Users Copyright Associated Chemists (Wicker) Ltd A|.A|. 23KL  "*?@A\]^d   ( ) * U^U^UccUc$^2ܥe-  \   gqqqqqqqqqqqqqqqqTqqqqqqqqqqqqqqSupervised Administration and Prescription Support Client Registration Form Name and Address of client: Name and Address of Pharmacy: We are pleased to welcome to you to this scheme. You will be issued with a sheet listing the rules that apply to the scheme. In addition we may ask for a photograph to attach to our record. This enables us to be certain that the correct person is issued with your medication even if we have different staff on duty. We also ask you to note that this scheme involves us reporting back to the prescribing team and to the service co-ordinator details of collections, missed doses and breaches of the rules. In addition, Sheffield Health, who fund the scheme, reserve the right to examine our records. Should you decide to change pharmacies then we ask you to note that your records may be passed to the new pharmacy. We hope the scheme proves helpful to you. Can we point out that we have available various leaflets covering harm reduction and self-help groups. All pharmacies taking part in this scheme have facilities to accept for destruction, used syringes & needles, provided they are in small sized sharps containers, which we have available. Larger containers should be returned to the Rockingham Drugs Project on Rockingham Street. I have read the information above and have been provided with the leaflet entitled Instalment Prescriptions - The Rules. I give my consent to share my information in the manner described above. Signed Date PRINT NAME Co-ordinated Pharmacy Services for Drug Users Copyright Associated Chemists (Wicker) Ltd A|.A|. 23KL  "*?@A\]^d   ( ) * U^U^UccUc$^23LMNjklmno ]^  ) * S<#SV -1H0H%/& ' ( ) SS&