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Donated Medication Forms

Unused Medication Program Forms

Instructions for Utilization of Unused Medication Program  

Participation Form-Donating Entities

Participation Form-Clinics & Qualifying Centers

Adult Care Home- Unused Medications Manifest and Declaration

Mail Order Pharmacy & Medical Care Facility- Unused Medications
Manifest and Declaration


Unused Medications Manifest

Indigent Care Clinic Application
(**You must be registered with the Board of Pharmacy as an
  indigent care clinic before you can participate in the program.**)

Statutes & Regulations 
  • K.A.R. Article 18.  Utilization of Unused Medications
  • 65-1668. Utilization of unused medications act; not applicable to certain medications.
  • 65-1669. Same; definitions.
  • 65-1670. Same; duties of the board of pharmacy; duties of qualifying center or clinic. 
  • 65-1671. Same; criteria for accepting unused medications; dispensing. 
  • 65-1672. Same; participation; adult care homes; powers and duties of qualifying center or clinic.
  • 65-1673. Same; criminal and civil liability under the act.
  • 65-1674. Same; rules and regulations; duties of the board of pharmacy.
  • 65-1675. Same; duties of the secretary of health and environment; records.