3-16. THE SIGNATURE CARD (DD Form 577)
A prescriber who works in an Army MTF should provide the pharmacy in some
manner with a representative signature. Normally this is accomplished by the
preparation of the signature card (DD Form 577 - figure 3-10). Persons assigned to the
pharmacy should familiarize themselves with the signature of the persons authorized to
write prescriptions to guard against possible forgeries. When prescriptions received in
the pharmacy are not readable or there is a question concerning the authenticity of the
prescription, dosage, compatibility, or directions to the patient, clarification must be
obtained from the prescriber before the medication is dispensed to the patient. The
signature card file should be updated monthly (TM 8-260)
Figure 3-10. The signature card (DD Form 577).
All prescriptions and orders filled by the pharmacy will be placed in files
established and maintained in the pharmacy. Prior to filing, prescriptions must be
numbered serially, checked to ensure the Uniform Chart of Account (UCA) Code is
shown, and initialed by the person who filled them. Three or more series of numbers
must be used. A corresponding file must be established for each series of numbers.
Immediately following are the minimum types of numbering files which can be
established:
a. Note R Items. Included in this file would be prescriptions for Schedule II
controlled substances, alcohol, and alcoholic liquors.
b. Note Q Items. Included in this file would be prescriptions for Schedules III,
IV, and V controlled substances.
c. All Other Medications. Included in this file would be prescriptions for
medications which are neither Note Q or Note R items.
MD0810
3-25