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SUBJECT: EFFECTIVE DATE

Page 1 of 9 SU BJE C T : MEDICATION REFILL STANDING ORDER EFFECTI VE date : July 2011 Oral contraceptives updated 8/10/11 Compliance definition, exclusions and numerous screening parameters updated 10/25/11 Clonidine monitoring updated 11/22/11 Statin monitoring updated 3/9/12 APPROVED FOR USE AS A POPULATION BASED STANDING ORDER BY: SU PE R SE D E S: July 2010 REVI EW date : July 2012 PURPOSE: To provide a process for RNs and Pharmacists to review and approve maintenance prescription refill requests.

EFFECTIVE DATE: July 2011 Oral contraceptives updated 8/10/11 Compliance definition, exclusions and numerous screening parameters updated 10/25/11 Clonidine monitoring updated 11/22/11 Statin monitoring updated 3/9/12 APPROVED(FORUSEASAPOPULATION(BASEDSTANDINGORDER( BY:

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