MMS Documents

Below is a list of relevant MMS documents for download.

To download each document, click the appropriate link in the table below.

Available Files

Click each link below to download file

MMS Operations Manual
docx (238 KB)

Registration for MMS Referrals
pdf (32 KB)

To receive referrals for MMS, please complete and submit this form.

Canterbury MMS Form 1 - Referral Form
pdf (312 KB)

Use this form to refer people to an accredited pharmacist for a Medication Management Service review.

Canterbury MMS Form 1 - Referral Form (Word Doc)
docx (58 KB)

Use this form to refer people to an accredited pharmacist for a Medication Management Service review.

Canterbury MMS Form 2 - Communication Form
docx (24 KB)

Canterbury MMS Form 3 - Quick data Collection Checklist
doc (73 KB)

Use this form to as a checklist to ensure you have covered all areas associated with medicine use reviews. These areas do not have to be covered in the first appointment, so this checklist will then act as a guide for the things you may still need to

Canterbury MMS Form 4 - Outcomes Report
pdf (54 KB)

Sample MMS Outcomes Report document

LOTS Medication Profiles
docx (170 KB)

LOTS Medication Profiles & DHB Med Card Help

Sample Patient Plan
doc (41 KB)

MMS Patient Consent Form
pdf (109 KB)

Medication Management Service Consent Form

Canterbury MMS Form 5 - GP Report
docx (368 KB)

Community Pharmacy Process for New Medication Oversight Patient Referrals
docx (17 KB)

Canterbury MMS Form 6 - Patient Plan
doc (38 KB)

PC Follow Up Form for Care co/ District Nurse
docx (17 KB)

Canterbury MMS Form 7 - Medicine card
doc (377 KB)