Patient/Caregiver Ad Hoc Education Template

This standardized template is designed to provide simple instructions to patients and caregivers for the safe ad hoc preparation and administration of investigational agents in a home setting. The template can be downloaded and used for non-CTEP IND agents or commercial agents to fulfill the institutions needs.

• Patient/Caregiver Ad Hoc Sample Form (MS Word)
• Patient/Caregiver Ad Hoc Template (MS Word)

If you have any difficulty opening or completing the template, contact the Pharmaceutical Management Branch by telephone (240-276-6575) Monday through Friday between 8:30 am and 4:30 pm (ET) or email PMBafterhours@mail.nih.gov anytime.