Resident Name, Month, Year and Day of the month.
Medication: Medication Name And Instructions For Use, with the Time Of Day.
Signatures: Signature and Initials of Each Person Signing.
Completion: Mandatory.
Authority: 1979 PA 218.
| Question | Answer |
|---|---|
| Form Name | BCHS-3267 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 756 |
| Avg. time to fill out | 60+ min |
| Edition | Rev 11-25 |
| Issuing agency | Michigan Department of Licensing and Regulatory Affairs |
| Other names | BCHS-3267, BCHS 3267, 3267, A.F.C. Resident Medication Record, AFC Resident Medication Record |
| Official source | BCHS-3267 (Rev 11-25), Michigan Department of Licensing and Regulatory Affairs |
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