The directions to the patient.
The refill instructions.
(9) The statement "TO BE FILLED ONLY AT (name of local medical
treatment facility) PHARMACY"--if the prescription was written by a nurse clinician,
graduate physician assistant, physical therapist, or AMOSIST.
(10) The signature of the prescriber--signed in ink on the day the prescription
(11) The rank and the degree of the prescriber.
d. Information Required on the Prescription Form for a Controlled
Substance. The following information is required on the prescription form for a
controlled substance in order for it to be filled by the pharmacy service of an Army
medical treatment facility. (See figure 3-3.)
Figure 3-3. Prescription for a controlled substance.