Non-exhaustive list of elements to be included in medical prescriptions issued in the other Member State of the European Union

Headings appearing in bold in this Annex are not required to feature in prescriptions

Identification of the patient

Surname(s)

First name(s) (written out in full, i.e. no initials)

Date of Birth

Authentication of the prescription

Issue date

Identification of the prescribing health professional

Surname(s)

First name(s) (written out in full, i.e. no initials)

Professional qualification

Details for direct contact (email and telephone or fax, the latter both with international prefix)

Work address (including the name of the relevant Member State)

Signature (written or digital, depending on the medium chosen for issuing the prescription)

Identification of the prescribed product, where applicable

‘Common name’ as defined by Article 1 of Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use

The brand name if:

(a) the prescribed product is a biological medicinal product, as defined in point 3.2.1.1.(b) of Annex I (Part I) to Directive 2001/83; or

(b) the prescribing health professional deems it medically necessary; in that case the prescription shall shortly state the reasons justifying the use of the brand name

Pharmaceutical formulation (tablet, solution, etc.)

Quantity

Strength, as defined in Article 1 of Directive 2001/83/EC

Dosage regimen