Pharmaceutical Society of New Zealand


Course Details and Enrolments
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Following is a complete set of the forms that are recommended for use when undertaking CPC® consultations. There is one copy of each of the forms. 

 When using these forms please use this set as a master set.  Create a new set for each new patient by using the "save as" method. (Right mouse click on form name and follow directions in the "Save Target As" dialogue box). 

If you have any queries please phone  04 802 0030 or email

CPC Forms

Drug Information Form

Informed Consent

Drug information

Patient History

CPC Patient Care Plan

CPC Recommendation to Doctor

PRS Claim Form

PRS Form 1 Resident Medication Profile

PRS Form 2 Intervention Record Form
PRS Forms 3 Action and Interventions
PRS Forms 4 Medical History