Medication Administration Record (MAR) Subforms List

Introduction

This page contains a list of medication administration record subforms for internal staff use and to be completed on the foster family website as well as what fields are available on each. These subforms pull in the medications entered on the case file in the Health tab > Medicalizations tab in real time.

Prerequisites

An extendedReach User ID with one of the following user permissions:

Full Administrator
Restricted Administrator - Forms Administration

Instructions

Search for a subform by either scrolling or using the find feature on your browser (CTRL + F)
Copy the subform name by highlighting it, right clicking and selecting copy or by using the keyboard shortcut of CTRL + C
Add to a program report type configured for a MAR subform Adding Medication Administration Record (MAR) Subforms

MAR Subforms

For Internal Use

Subform	Fields
S_Case_MAR	Pulls in medications 1-15 on the medications tab Month Year Allergies Medication Name Dosage/Rx Instructions Prescribed on Discontinued on Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Not Given Client Refused See Notes Notes File attachment
S_Case_MAR_DDM	Pulls in medications 1-13 on the medications tab Month Year Allergies Medication Name Dosage/Rx Instructions Reason RX # Refills Left Prescribed by Start on Stop on Time Days 1-31 Box with the option of: Medication Given Not Given - (L) LOA Not Given - (P) PRN Not Given - (R) Refused Not Given - (H) Held by MD Not Given - (M) Missed Dose (requires incident report) Pill Count/Liq Doses Side Effects/Contradictions Notes File attachment
S_CASE_MAR_DDM14	Pulls in medications 14-26 on the medications tab Month Year Allergies Medication Name Dosage/Rx Instructions Reason RX # Refills Left Prescribed by Start on Stop on Reason Time Days 1-31 Box with the option of: Medication Given Not Given - (L) LOA Not Given - (P) PRN Not Given - (R) Refused Not Given - (H) Held by MD Not Given - (M) Missed Dose (requires incident report) Pill Count/Liq Doses Side Effects/Contradictions Notes File attachment
S_CASE_MAR_CF	Pulls in medications 1-13 on the medications tab Month Year Allergies Medication Name Dosage/Rx Instructions RX # Refills Left Prescribed by Start on Stop on Time Days 1-31 Box with the option of: Medication Given Not Given - (V) Home Visit Not Given - (S) School Not Given - (A) AWOL Not Given - (H) Hospitalized/Detained Not Given - (R) Refused (must submit incident report) Not Given - (D) Late Delivery Not Given - (P) PRN Not Administered Not Given - (N) Medication Not Available (must submit incident report) Not Given - (M) Missed Dose (must submit incident report) Not Given - (C) Medication Completed Not Given - (O) Order Held by MD Pill Count/Liq Doses Side Effects/Contradictions Notes File attachment
S_CASE_MAR_CF14	Pulls in medications 14-26 on the medications tab Month Year Allergies Medication Name Dosage/Rx Instructions RX # Refills Left Prescribed by Start on Stop on Time Days 1-31 Box with the option of: Medication Given Not Given - (H) Home Visit Not Given - (S) School Not Given - (A) AWOL Not Given - (H) Hospitalized/Detained Not Given - (R) Refused (must submit incident report) Not Given - (D) Late Delivery Not Given - (P) PRN Not Administered Not Given - (N) Medication Not Available (must submit incident report) Not Given - (M) Missed Dose (must submit incident report) Not Given - (C) Medication Completed Not Given - (O) Order Held by MD Pill Count/Liq Doses Side Effects/Contradictions Notes File attachment

For Foster Family Website Use

Subform	Description
F_FRM_MAR	Pulls in medications 1-15 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given by EBP (EBP) Medication Given by EEP (EEP) Medication Given by Other (O) Medication Not Given (X) Client Refused (R) See Notes (N) Notes File attachment
F_FRM_MAR_15_30	Pulls in medications 16-30 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Given by Other (O) Medication Not Given (X) Client Refused (R) See Notes (N) Notes File attachment
F_FRM_MARS	Pulls in medications 1-15 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Not Given Client Refused See Notes Notes File attachment Signature Signature Name
F_FRM_MARS2	Pulls in medications 1-15 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Not Given (X) Client Refused (R) See Notes (N) Notes File attachment Signature (Parent) Signature (Child)
F_FRM_MARS3	Pulls in medications 1-15 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Not Given (X) Client Refused (R) See Notes (N) Notes File attachment Signature (Parent A) Signature (Parent B)
F_FRM_MAR_CC	Pulls in medications 1-15 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Given at School (S) Medication Not Given (X) Client Refused (R) See Notes (N) See Notes (N) - Fill All Days Notes File attachment
F_FRM_MARPC	Pulls in medications 1-13 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Given by Other (O) Medication Not Given (X) Client Refused (R) See Notes (N) Pill Count/Doses Notes File attachment
F_FRM_MARPC_14_26	Pulls in medications 14-26 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Given by Other (O) Medication Not Given (X) Client Refused (R) See Notes (N) Pill Count/Doses Notes File attachment
F_FRM_MARPC_27_39	Pulls in medications 27-39 on the medications tab Client Name Date of Birth Month Year Medication Allergies Medication Name Dosage/Rx Instructions Reason Prescribed On Discontinued On Prescribed by Time Days 1-31 Box with the option of: Medication Given Medication Given by Other (O) Medication Not Given (X) Client Refused (R) See Notes (N) Pill Count/Doses Notes File attachment

FAQs

Q: Can we add, remove or changes the fields on these forms?

A: No, these subforms are not able to be customized.

Related to: