Controlled Substance Usage Log (for solutions only)

Form Template

Usage is tracked on a per dose (use) basis and the log balance must match the physical balance of the solution at all times.

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Complete the Controlled Substance Usage Log (for solutions only) mobile app in its entirety for each container. Record total quantity to the nearest metric unit weight or the total number of units finished form. This log sheet does not replace the log for your original CS container. The purpose of this log sheet is for the lab to track the concentration and the remaining volume in all solution vials that contain a CS. Do not exhaust the entire CS bottle in creation of one solution. Only Authorized Personnel on the CSUA are permitted to dispense and use CS per CSUA- approved protocols.

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