After writing a prescription under Vermont's Patient Choice at End of Life law, the prescribing physician reports back to the Department of Health on how the patient died. The one-page form asks for the patient's name and date of birth, the prescriber's name, and whether death came from the prescribed medication, the underlying illness, another cause such as terminal sedation or ceasing to eat or drink, or is unknown.
The prescribing physician completes and signs the form. The Department will accept it only when signed by the prescribing physician, whether or not they were present at the patient's time of death.
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Prescribing Physician Follow up Form
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Within 10 calendar days of the patient's death when the physician knows of it, or 60 calendar days from the date the prescription was written. The deadline comes from the Department of Health's Rule Governing Compliance with Patient Choice at End of Life and is printed at the top of the form.
No. The form says the Department accepts it only if the prescribing physician signs it, whether or not they were present at the patient's time of death. Report the cause as best you know it: Patient Choice (lethal medication), underlying illness, unknown, or other with a description.