This page provides a list of all questions found on the PSRP reporting form for pharmacies. They are grouped alphabetically by the section of the form in which they appear. This list does not indicate which questions are required for all pharmacy reports nor which questions only appear for certain event types. A list of required questions can be found here: Required Fields for Pharmacies.
General Information
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "general_information" and label != "test" and space = currentSpace ( ) |
|---|
|
...
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "harmsummary_information" and space = currentSpace ( ) |
|---|
|
...
Harm Category
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "event_informationharm" and space = currentSpace ( ) |
|---|
|
Event
...
Medication or Other Substance Event-Specific Questions
Information
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "medicationevent_eventinformation" and space = currentSpace ( ) |
|---|
|
...
Event Type-Specific Questions
Medication or Other Substance Event-Specific Questions
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "contributingmedication_factorsevent" and space = currentSpace ( ) |
|---|
|
...
Contributing Factors
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "reviewcontributing_informationfactors" and space = currentSpace ( ) |
|---|
|
...
| Filter by label (Content by label) |
|---|
| showLabels | false |
|---|
| max | 100 |
|---|
| sort | title |
|---|
| showSpace | false |
|---|
| cql | label = "form_field" and label = "pharmacy" and label = "summaryreview_information" and space = currentSpace ( ) |
|---|
|