Sandoz Fentanyl Patch Return Sheet · 2017. 3. 30. · N Sandoz® Fentanyl Patch Return Sheet....

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If you would like to learn more about this program, ask your pharmacist or healthcare professional. Use this sheet to keep and return ALL of your used patches. Your pharmacist and doctor participate in the Fentanyl Patch Return Program. You must bring your USED fentanyl patches back to the pharmacy in order to pick up a new prescription of your patches. Instructions: 1. Once you remove a used patch from your skin, stick the used patch on this sheet in the designated boxes. 2. Store this sheet out of sight and out of reach of children/pets. 3. After applying your last patch, return this sheet with the used patches to the pharmacy in order to pick up your next supply. Sandoz Canada Inc. 145 Jules-Léger, Boucherville QC J4B 7K8 Customer Service: 1-800-361-3062 or 514-596-0000 www.sandoz.ca Customer Service: 1-800-361-3062 or 514-596-0000 Safety First Help make our community safer! N Sandoz ® Fentanyl Patch Return Sheet

Transcript of Sandoz Fentanyl Patch Return Sheet · 2017. 3. 30. · N Sandoz® Fentanyl Patch Return Sheet....

  • If you would like to learnmore about this program,ask your pharmacist orhealthcare professional.

    Use this sheet to keep and return ALL of your used patches.

    Your pharmacist and doctor participatein the Fentanyl Patch Return Program.You must bring your USED fentanyl patches back to the pharmacy in order to pick up a new prescription of your patches.

    Instructions:

    1. Once you remove a used patch from your skin, stick the used patch on this sheet in the designated boxes.

    2. Store this sheet out of sight and out of reach of children/pets.

    3. After applying your last patch, returnthis sheet with the used patches tothe pharmacy in order to pick up yournext supply.

    Sandoz Canada Inc. 145 Jules-Léger, Boucherville QC J4B 7K8Customer Service: 1-800-361-3062 or 514-596-0000www.sandoz.ca

    Customer Service: 1-800-361-3062 or514-596-0000

    Safety First

    Help make ourcommunity safer!

    N Sandoz® FentanylPatch Return Sheet

  • Thank you for helping make ourcommunity safer!

    Patient Rx Label

    Number of patches returned:

    Date returned: DD / MM / YYYY

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA

    Place used patch here.

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA

    Place used patch here.

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA

    Place used patch here.P

    lace

    use

    d pa

    tch

    here

    .

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA

    Pla

    ce u

    sed

    patc

    h he

    re.

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA

    Pla

    ce u

    sed

    patc

    h he

    re.

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA

    N Sandoz® FentanylPatch Return Sheet

    Pla

    ce u

    sed

    patc

    h he

    re.

    12 mcg/h 5TTSS CA

    25 mcg/h 5TTSS CA

    37 mcg/h 5TTSS CA

    50 m

    cg/h

    5T

    TS

    S C

    A

    75 mcg/h 5TTSS CA

    100 mcg/h 5TTSS CA


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