Practice Controlled Drugs (CD) Self-Assessment and Declaration Form

Closed 30 Jun 2023

Opened 9 Mar 2021


DoH CD Accountable Officer (AO) has a legal responsibility to seek assurance that CDs are managed appropriately across primary care including by individual GPs. Please complete the CD Self-Assessment and Declaration below on behalf of the practice.

The completed form should be discussed and agreed with all prescribers, and verified by the Practice Governance Lead, before submission. Please refer to the cover letter for further guidance on the safe management of CDs. Common examples of CDs in each Schedule can be found in Appendix 2 of the cover letter.

Note:  No patient/carer or staff identifiable information should be included in the self-assessment responses.



  • Health professionals


  • Provision of health and social care services