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Eureka-Pharmacy - Controlled I-bstances Return Procedure Page 1 of 2 <br /> Workbench Home About Target Shared Toots Training&Deevelopment Storl <br /> Process F t• I K SalesFloorResources <br /> myTraining&Development r� r ,lr <br /> Controlled Substances Return Procedure <br /> Process C-II items separately from CIII-V items. <br /> 1. Print a blank return form. <br /> Click here for a blank Controlled Substance Return Inventoryfform. <br /> Fill in your store information in the upper section of the form including: Store Name and #, Address, <br /> Phone Number, and DEA Registration Number. <br /> 2. Complete all fields for each line item on the form. Use as many Controlled Substances Inventory <br /> forms as necessary per box. Product listed on the form(s) must match the product in the box. <br /> • Itemize each container on a separate line. <br /> • Do not combine partials with partials. <br /> • Do not combine partials with full containers. <br /> - No. of Packages refers to the number of containers (bottle, vial, etc.) <br /> - Quantity refers to the exact quantity within the container. <br /> - Name of Item/Dosage/Strength refers to the product name, description, and <br /> strength <br /> - Full Unit Size refers to the size of the full container <br /> - 11-digit NDC Number: 11-digit National Drug Code <br /> - Drug Class refers to Class 2 through 5 Controlled Substances. <br /> 3. Number each page used the in upper right corner of the form. <br /> Ex. Page 1 of 2, Page 2 of 2, etc. <br /> 4. Add up the total number of packages for a single page and enter the quantity in the Total # <br /> Packages this page field (bottom left-hand corner). <br /> 5. Add up the `Total #of Packages This Page' quantities for all pages for the box. Enter this quantity <br /> in the Total No. Packages in Box field (upper left corner) on page one only of that box's <br /> documents. <br /> 6. Place Controlled Substances into the shipping box. <br /> For liquids, please make sure containers are tightly closed and are returned in a <br /> padded, sealed bag inside the box to prevent leaking. <br /> 7. Apply the return-shipping label to the box. Write the tracking number(from shipping label) in the <br /> Box Tracking Number space (upper right) on the first page of the return form(s). Each inventoried <br /> box should contain a separate shipping label with a separate box tracking number. <br /> 8. Complete the remaining fields on the return form including: <br /> Date Form Completed —the date the form is completed <br /> http://eureka.target.com/ShowPage.aspx?rank=5&id=b4967360-304c-4d95-a515-1 c82eb9... 3/10/2008 <br />