Run Grocery Pharmacy Drug Recall Response Log — Free

Inspection Details

Recall notice identified and logged critical (required)

Confirm the recall notice has been received, reviewed, and entered into the recall response log.

Yes No N/A

Recall identifier documented critical (required)

Enter the recall number, notice ID, or manufacturer recall reference.

Inspection date and responsible pharmacist recorded

Document when the recall response review was completed and who performed it.

Affected Product Identification

Affected NDC numbers documented critical (required)

List all affected NDC numbers associated with the recall.

Affected lot numbers documented critical (required)

Record the lot numbers included in the recall, if applicable.

Expiration dates verified against recall scope

Confirm expiration dates were checked against the recall notice and inventory records.

Yes No N/A

On-hand quantity of affected product counted critical (required)

Enter the quantity of recalled product found in stock.

Note (optional)

Dispensed quantity identified from records

Enter the quantity of recalled product previously dispensed to patients, if traceable.

Note (optional)

Quarantine and Inventory Removal

Affected stock removed from active inventory critical (required)

Confirm all identified recalled stock has been removed from saleable inventory.

Yes No N/A

Recalled product placed in designated quarantine area critical (required)

Confirm recalled product is segregated in a clearly labeled quarantine location.

Yes No N/A

Quarantine label applied

Confirm the quarantined product is labeled with recall status, date, and responsible staff initials.

Yes No N/A

Inventory system adjusted to prevent dispensing critical (required)

Confirm the pharmacy system has been updated to block or flag the recalled product.

Yes No N/A

Physical segregation verified critical (required)

Confirm recalled stock is physically separated from non-recalled stock and not accessible to customers.

Yes No N/A

Patient and Prescriber Notification

Affected patients identified from dispensing records critical (required)

Confirm the pharmacy reviewed dispensing records to identify potentially affected patients.

Yes No N/A

Patient notification completed or attempted critical (required)

Document the notification status for affected patients.

Note (optional)

Prescriber notification completed or attempted

Document whether prescribers were notified of the recall, if required by policy or recall severity.

Note (optional)

Patient contact method documented

Select all methods used to contact affected patients.

Note (optional)

Disposition and Corrective Actions

Final disposition documented critical (required)

Record how the recalled product was handled at the end of the response process.

Note (optional)

Return or destruction documentation retained critical (required)

Confirm proof of return, destruction certificate, or equivalent disposition record is on file.

Yes No N/A

Root cause or process gap identified

Confirm whether a process gap, storage issue, or dispensing control issue contributed to the recall response risk.

Yes No N/A

Corrective action documented critical (required)

Describe any corrective action taken, such as staff retraining, inventory system updates, or recall workflow changes.

Sign-Off and Reference

Inspection comments and exceptions recorded

Summarize any deficiencies, non-conformances, or open follow-up items.

Reference document linked

Enter the recall notice, SOP, or policy reference used for this response log.

Inspector signature critical (required)

Signature of the pharmacist or authorized inspector completing the recall response log.

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Run: Grocery Pharmacy Drug Recall Response Log

Inspection Details

Affected Product Identification

Quarantine and Inventory Removal

Patient and Prescriber Notification

Disposition and Corrective Actions

Sign-Off and Reference

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