Templates and worksheets.
Starting-point templates for prescribers, patients, and receiving pharmacies. Adapt before you sign.
A small working library of templates and checklists for prescribers, hospital pharmacies, and families who want to prepare before they speak with us. Each tool on this page is intended as a starting point, not a final instrument; the documents should be adapted by the prescriber, the institution's compliance officer, or local counsel to the specific facts of the case and to local law. None of these templates constitutes legal or medical advice.
For prescribers
The medical-necessity letter template provides a short framework for the letter that most named-patient pathways require. A treating physician can adapt the template to the patient, the indication, and the destination country's expectations in well under an hour. Where local requirements call for specific language, the prescriber's compliance officer should add that language before the letter is signed.
For patients and families
The named-patient consent template is a jurisdiction-generic consent document that covers the cross-border coordination, the cold-chain logistics, and the pharmacovigilance obligations of a typical named-patient case. A local medical-legal adviser should adapt the document to local privacy law and to the specific institution's consent framework before it is used. The template is offered as a drafting aid, not as a substitute for counsel.
For hospital pharmacies
The receiving checklist is a condensed, printable version of the incoming-shipment inspection protocol described in full on the hospital pharmacy receiving protocol page. The checklist is designed to sit on a receiving desk for reference; the full protocol page is designed to inform the underlying SOP.
How to use these tools
Download, read, and adapt. The templates are written in editorial English rather than formal legalese, because a document that cannot be read is not a document that will be signed carefully. Where any tool conflicts with local regulation, the local regulation controls, and the tool should be adjusted or discarded accordingly. Where any tool is used in connection with a case we are coordinating, we are happy to review the adapted version before it is signed; send a draft to [email protected].
What we plan to add
The tools library is a living resource. Planned additions include a cold-chain handling briefing note for infusion centers, a pharmacovigilance routing worksheet for treating prescribers, and a short checklist for family members preparing for a first consultation with us. If there is a specific template that would be useful to your practice or institution, we welcome the suggestion.
Reviewed 2026-04-22 by Reserve Meds’s AI clinical and regulatory review agents. Human pharmacist-in-charge: Altima Care. Next scheduled review: 2026-10-22.