PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
the document
for the current year.
Prescription Drug Attestation - California
Prescription Drug Attestation is a legal document that was released by the California Department of Managed Health Care - a government authority operating within California.
FAQ
Q: What is a prescription drug attestation?
A: A prescription drug attestation is a form that certifies that the individual receiving the prescription has a legitimate medical need for the prescribed medication.
Q: Why is a prescription drug attestation required?
A: A prescription drug attestation is required to prevent misuse and abuse of prescription medications.
Q: Who needs to complete a prescription drug attestation?
A: Anyone who is receiving a prescription medication that requires an attestation must complete the form.
Q: What information is included in a prescription drug attestation?
A: A prescription drug attestation form typically includes information about the individual receiving the prescription, the prescribed medication, and the medical condition for which it is being prescribed.
Q: Are prescription drug attestations required in all states?
A: No, prescription drug attestation requirements may vary by state. It is best to check with your healthcare provider or pharmacist to determine if it is required in your state.
Q: Can I refuse to sign a prescription drug attestation?
A: While it is ultimately your choice, refusing to sign a prescription drug attestation may result in a denial of the prescription medication.
Q: What are the consequences of providing false information on a prescription drug attestation?
A: Providing false information on a prescription drug attestation can have legal consequences and may result in criminal charges.
Q: Is a prescription drug attestation the same as a prescription drug label?
A: No, a prescription drug attestation is a separate form that certifies the medical need for the prescription, while a prescription drug label provides information about the medication and its usage instructions.
Q: How long is a prescription drug attestation valid?
A: The validity period of a prescription drug attestation may vary. It is best to check with your healthcare provider or pharmacist to determine the specific duration.
Form Details:
- The latest edition currently provided by the California Department of Managed Health Care;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Managed Health Care.
