27 tal-1984

L.N. 27 of 19IiJ

Mt:OICAL AND KINDRED PIIOn:.sSIQNS ORDL"ANCt

{CAP. SI )

IN e).ercise of the powers <;onfem.:d by paragraph (h J ofsubsecrion

(I) o f ~ttio<l6 oflhe Medic;o.l and Killdred Prof~ions Ordi nance. lhe

Miniliter of Health kas made the following regulations:-

I. Tkes<: regulations may be cited as the Fro:.: Medidnals (Pres'

cription Forms) Regulations. 19liJ, and shall come into force On 1st July

'9&>.

Reg. 2(3)

PRESCRIYfIQS ~"OR NARCOTIC AND PSYC HOTROPIC DR UGS '

(Only OM ilt m may be p~rlbed on Ihis t'onn)

•

<. TO It: muo IY

'tU I,. tl LUD BY .... ;<iCt.I~ tII

.o,POTHECAIl r

[I I SI'l(~S I ,~G

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r-:."", .f>(! $om_

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Pt."'",,'"'' r.,.- METII",'J(I~E

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LOCATIOr<.DISPENSf:O

s..-Io,1 No.

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IICT'o No

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THIRD SCHEDU LE

Reg. J

k EQUES T fOR PHESCRIPT I O~ ~'ORMS FO H

FHEE MEDICINAlS

I requesl .......... bookk!/i by •...•..... pfelaiplion forms

Name and Su rname of Pre5Criber

,N

Private Address .... .... ..•......

( IN BLOCK L ETIERS)

~

Med. Council Reg. No . i L~'~'~~...J

Signature ................... •......

fOH OfFICIAL US E

Supplied .......... booklet/$ by .......... prescription fonns

Serial No ............... to ........ .

If ,..ilhdra ... ·n pefWn~lIy by prescriber.

(a)

Signature of P,eiICril>er

Date

(b)

Iffo .... ·ardcdbyrnail.

FO""'arded by • . . . . . . . . . . . . . . • . . . . . . . ..

Qfl •.•....•..•.•..•....•.•..•......

... R.Conl ...... _ _ .

•

,46

PIU:SCfU PTlON ~'OIl;M S rot(,

iU:Q U~: ST ~'O R

NAR C OT IC AN D PSVC II QTRQI' IC DNOGS

I request .. . ....... bookletls by . . ........ prescription forms

Name and Surname of Prescriber

,,~ ' • • 0 ""

Private Add ress ................ , .... . _ ... " .... , .. . ....................... .

(I N BLOCK LETfERS)

Med . Council Reg . No. ,I ~~~~---'

Signat ure . .. .... .. ...... , .. .. ... ..

OK OFFICIAL USE

tO

Supplied .. .. .... .. bookletls by ..... ... .. prescription forms

Serial No ............... 10 ............. .

(D)

If withdra wn personally by pre5(riher .

. . . . . . . . . . .. ... .......... , - .

","

Dale

Signature of Prescriber

(b)

Ifforwarded by mail.

FOI""arded by ... . . . . . . . . . . . . . . . . . . . . ..

on .... .... .... . . . .. ..• ..... .. ... •.

If'P'lll>lik., .. ;'·n.l' .... ",.T""'n f _ K ... il," 1'Io/Jo/Wwd"., '" I~""_ 0;,,,,,,,"

M;' ''''P ft.l~l' , 1Il'().'< .. _ I'rltw.t _ /lot (;6, . ""'N d ~ ,.,. ...

(I) These regulations shall apply to every fonn ~ in pre'

scribing any medici na l .... hic:h is suppl ied free asmentioned in pangraph

(h ) of subsection ( 1) of sccrion 6 of the Medical and Kindred Profes·

sions Ordinance.

(2) The form .... hkh shall be us<:d by a medkal pract itione r

... ·hen prescribing a medicinal (except a medicinal falling under the

Dangcrou§ Drugs Ordinance. or under the Drugs (Control) Regula· Cop. tflt

tions. 1976) to a palient entitled to a medical aids gram under lhe \..N jt

.,~

Nat ional AssisIance Act. 1956. sh all be the form !>et out in the Firsl

Schedule 10 these 'egulalions.

(3) The form which shall be used by a medio:aJ p.-a(titioner

""hen prescribing a medicinal falling unde r the Dangel"OUS Drugs Ordi·

nance. or under t he Drugs (Conlrol ) Regulations. 1976. lo a pat ient as 's

referred to under paragraph (2) of Ihis .egula tion shall be lhe form set

out in the Sc<;ond S<:hedule to these fCgulations.

(4) It shall be the duty o f Ihe medieal prllClitioner 10 1111

clearly and in a legible manner all de tails mentioned in Pan A of $tICh

forms .

(5) In prescribing medicinalso. other medical aid refe.n:d 10

in paragraph (2) of this regulation. it shall nol be la .... ful for a medical

practitione r to prescribe mo~ Ihan an aggregate of three sllCh medicinals

or items on any single form .

(6) In preSl:ribing any medicinal referred 10 in paragraph (3)

o f this regulation. a medical practi tioncr shall u'ie a separatc fonn in

.espect of each and every such medicinal.

J . (I) Every medical practitioner shall in prescribing medid nab Pr"""", ...

as are referred to in these regulations. make use OtIl y of the booklet of bookk ...

forms bearing ~rial numbers and issued 10 him by the Superintendent of

Publie Health.

(2 ) 11 shall not be lawful for any pratti lio n(f to mak e use of

any preSl:ription form except (.om a boo klet whkh is issued 10 him

personally.

(3) I1 shall be lhe dUly of e"cry ITIC'dical praclilionc' , ",-helhe.

for IIIe purpose of his pri\'ale praclict: or for carrying OUl his dUlics in an

official capacily as a rnull of his cmploymcnl .... ith Go'-crnmenl. wilh a

view 10 meeting the needs of his palicn~. 10 make any re'lucsl for such

prescriPlion booklets on the appropriale fo"" sel OUI in the Third

Schedule to lhese regulations, Such rcqunl form shall be con«Ily filled

in all respects and signed by the praclilioner. and shall be either handed

in by such praClilione r person ally 10 Ihe Chief i'hu.madsl at the (}Q,-em'

ment Medical Stores al G,,'ardamangia or s.:nt b)' post to Ihe

Superin lendem o f Public Health al the Department of Health in

ValLctta. When sent by ~t the rcq ~t $hall bo!'markcd "Public Health

Notifications" for the purpose of ucmption from poslage (LN , 67 of

1976).

(.j) Any prescripTion 10 whk h lhe.e rcgulaliom apply shall

be deemed (or all purposes of law to be made OOt by the medical

practitioner 10 " 'horn Ihe bookie! from " 'lIicll it "'a~ eulled ,,-a~ issued.

(5) It sllall be the duty of evel)' medical practitioner 10 report

in " 'riting forthwilh 10 lhe Superimendcnt of Publi<: Health an)' (;a';C of

theft or 10§S of any prescription booklets iMucd under thc!;c regulations.

... A n apothecary dispc:nsing a pl\:SCription to "'hich regulation 2

refers shall retain the prescription and no ITIC'dicinal shall be: supplied

more than once on the ~me prescription.

FIRST SCHED ULE

Rcg. 2(2)

PRESCRIPT ION FO R t·REE MEDlCINALS

(olh er Iha n Narro( ic a nd Psychot ropic Drugs)

Nol more Ihan Ihree items may be dispensed on this Fonn .

,.

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nLLED Ill' DlSP£."SI:J.

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ftE nI. LEO IIY I'tI:ESCIUIIER

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(i"d . Fotn'I &. Dot.c)

I'tI:f.SCRIPTIOI' ORIGIS

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(incl. fomI &. 0....)

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PRESCII;lnlOJ'i TYPE

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Pink f omt 0

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Quam"J

OOANTIIT SUPPLIED

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Item

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LOCATION DI SPENSED

PRESCRI8ER

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o. m" n LU·. o Ill' COD£R

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PRESCRIPTION O RIGIJ'i I , I

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Reg. 2(3)

PRESC RIP110N .'OR NA RCOTIC AND PSYCHOTROPIC DR UGS·

,.

(OnJyone item ma)' br prescribrd on th is f orm)

•• TO BE flI.U : O BV 1'Mt:.SClt llf.R

BE m .LEO IV

C.

OISI'ESSING APOTHt:CAItV

~AT I E.vr

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Total O".nlil~

in Un i" . . .

To.oI QILan".y

Addi. iona/ I~'''",lInion in laP«' 01

in We.pn./Me ...... ... . ..... . .. ..

Preocripoio ...... MlTHAiJOSE

Exp«l~d Du"'lion "fT.n"""nl

Pltt:SCltlPTlOS ORlm ."

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Medical lndiacioot .........

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PKfS("IUIIER

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LOCATI O N DISPENSED

Sn-lal No.

To bolll...,..,. C-.-

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IT·TIELET SKEDA

Rea. 3

REQ UES T FOR PR ESC RIPTION FORMS FOR

FREE MEDICINALS

I request .. ... .. ... bool<let/I by ...... . .•. pn:scriptil>n fonn~

Name and SurnalM of Pn:scribc r . ... ............. .. .........................

.

, ,,. ........ , ImI-.... ,

Private Address ....... .. ...... .. ....... ... . ........ ........... ........ . ... .

( IN BLOC K LETTERS )

Signature . . .. . .. .. .. .. .. .. .... .. . . Med. Council Reg . No . ll~, ~, ~

, _,w l

FOR Om CIAL USE

Supplied .......... bool<letjs by ...•.•.... pRKription fomtll

Scrial No ....... . .... ... to .. ... ........ .

(a)

Ifwithdrawn penonally by prncribcr .

SignalU~ of PT~bcr

lfforwarded b~ mail.

(b)

Forwarded by .... .. .......... .........

on ... .... ...... .. ..... . .......... .

~ . II . C."'Io Ilo_ .

B

\'"

REQ UEST FOR PRESC RIPTION FORMS FOR

NARCOTI C AND PSYCHOTROPIC DRUGS

1 request .. ,. , ..... boo kletk by ..• , ••.•.• ~p'ion fonns

Name and Surname of Pracriber ................................ , .... •... , . , .

, .. 0UlCII L,""",""

Priva tc Address ......... . . ...... .... . . ........... ......... ..... ...... "., ..

(IN BLOCK LElTERS)

-." ........................•...

Med. Council Reg. No. I L ~~~~-'

Signature ........... ...... . .......

FOR OnlClAL USE

Supplied .......... booklc l/I by .• .••.•... prescription lonns

Serial No .. •. .... ....... to . . . . ..... .... .

If withdrawn pel"$Of1 ally by prescriber.

(a)

Signature of Prncriber

Date

(b)

If forwarded by mail.

Forwarded by . . . ... . . .. .. • ...... .. ....

on .............•..................

A •• • Cor<l ..... _

.

Apotekarju li jaghti mediCinali fuq preskrizzjoni li ghaliha

jirreferi r-regolament 2 ghandu jt.omm il-preskrizzjoni u ebda mediCi-

nali ma jinghataw iktar minn darba fuq I-istess preskrizzjoni.