Run Retail Pharmacy Controlled Substance Count Verification — Free

Inspection Scope and Shift Details

Inspection date and shift recorded critical (required)

Record the date/time of the daily controlled substance count verification.

Note (optional)

Pharmacy location identified critical (required)

Enter the retail pharmacy site, store number, or location identifier.

Inspector and verifying pharmacist identified critical (required)

Document the employee completing the count and the pharmacist or authorized verifier.

Controlled substance count scope includes Schedule II-V stock critical (required)

Confirm the count covers all applicable DEA Schedule II-V controlled substances maintained in the pharmacy.

Yes No N/A

Physical Count Reconciliation

Physical count matches perpetual inventory for Schedule II items critical (required)

Verify each Schedule II controlled substance count matches the perpetual inventory or dispensing record.

Yes No N/A

Physical count matches perpetual inventory for Schedule III items critical (required)

Verify each Schedule III controlled substance count matches the perpetual inventory or dispensing record.

Yes No N/A

Physical count matches perpetual inventory for Schedule IV items critical (required)

Verify each Schedule IV controlled substance count matches the perpetual inventory or dispensing record.

Yes No N/A

Physical count matches perpetual inventory for Schedule V items

Verify each Schedule V controlled substance count matches the perpetual inventory or dispensing record.

Yes No N/A

Count method used consistently

Select the method used to perform the count.

Note (optional)

Storage Security and Access Control

Controlled substances stored in secured, access-controlled location critical (required)

Confirm controlled substances are stored in a locked or otherwise access-controlled area with restricted access.

Yes No N/A

No signs of tampering, diversion, or unauthorized access critical (required)

Inspect the storage area for signs of tampering, missing stock, broken seals, or unauthorized access.

Yes No N/A

Access limited to authorized personnel only critical (required)

Confirm only authorized pharmacy personnel have access to controlled substance storage and keys/codes are controlled.

Yes No N/A

Discrepancy Reporting and Corrective Action

Any count discrepancy documented critical (required)

Indicate whether any discrepancy was identified during the count reconciliation.

Yes No N/A

Discrepancy amount recorded critical (required)

Enter the quantity variance identified for the affected controlled substance.

Note (optional)

Affected drug and strength documented critical (required)

Record the medication name, strength, dosage form, and package size involved in the discrepancy.

Supervisor, pharmacist-in-charge, or compliance lead notified critical (required)

Confirm the discrepancy was escalated to the appropriate responsible party per policy.

Yes No N/A

DEA/state board reporting requirement reviewed critical (required)

Confirm the team reviewed whether the discrepancy requires internal investigation, DEA reporting, or state board notification.

Yes No N/A

Witness Verification and Sign-Off

Second verifier present when required

Confirm a second authorized employee or pharmacist verified the count when required by policy or for discrepancies.

Yes No N/A

Witness name and credentials recorded

Document the witness name, role, and credentials if a second verification was completed.

Inspector signature completed critical (required)

Inspector signs to confirm the count verification and documentation are complete.

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Run: Retail Pharmacy Controlled Substance Count Verification

Inspection Scope and Shift Details

Physical Count Reconciliation

Storage Security and Access Control

Discrepancy Reporting and Corrective Action

Witness Verification and Sign-Off

Get your results