ORDIN   Nr. 1204 din 27 septembrie 2004

privind aprobarea certificatului pentru detinerea de medicamente si substante stupefiante si psihotrope

ACT EMIS DE: MINISTERUL SANATATII

ACT PUBLICAT IN: MONITORUL OFICIAL  NR. 901 din  4 octombrie 2004

    Vazand Referatul de aprobare al Directiei generale farmaceutice, inspectia de farmacie si aparatura medicala nr. OB. 10.980/2004,
    in temeiul Hotararii Guvernului nr. 743/2003 privind organizarea si functionarea Ministerului Sanatatii, cu completarile si modificarile ulterioare,

    ministrul sanatatii emite urmatorul ordin:

    Art. 1
    Se aproba certificatul pentru detinerea de medicamente si substante stupefiante si psihotrope, prevazut in anexa care face parte din prezentul ordin.
    Art. 2
    Rezidentii unui stat din spatiul Schengen, aflati in calatorie pe teritoriul Romaniei, justifica detinerea unei cantitati de medicamente care contin substante stupefiante sau psihotrope in baza unui certificat emis de autoritatea competenta din statul de resedinta.
    Art. 3
    Ministerul Sanatatii, prin Directia farmaceutica, inspectia de farmacie si aparatura medicala, va emite un certificat persoanelor rezidente in Romania care doresc sa calatoreasca intr-un stat din spatiul Schengen si care, pe baza unei prescriptii medicale, au nevoie de medicamente ce contin substante stupefiante sau psihotrope. Certificatul va fi valabil cel mult 30 de zile.
    Art. 4
    Certificatul prevazut la art. 3 va fi emis pe baza unei prescriptii medicale. Pentru fiecare medicament este necesar un certificat separat.
    Ministerul Sanatatii va pastra o copie a certificatului.
    Art. 5
    Medicii pot prescrie medicamente stupefiante sau psihotrope pentru necesitatile de calatorie pentru maximum 30 de zile. Perioada de calatorie poate fi mai scurta decat aceasta durata.
    Art. 6
    Prezentul ordin creeaza cadrul legal pentru aplicarea Deciziei Comitetului Executiv din 22 decembrie 1994 privind certificatul pentru transportul stupefiantelor si substantele psihotrope prevazut la art. 75 al Conventiei de aplicare a Acordului Schengen, publicata in Jurnalul Oficial al Comunitatii Europene nr. L 239 din 22 septembrie 2000.
    Art. 7
    Prezentul ordin se publica in Monitorul Oficial al Romaniei, Partea I, si intra in vigoare la 30 de zile de la publicare.

                           Ministrul sanatatii,
                             Ovidiu Brinzan

    ANEXA 1*)

    *) Anexa este reprodusa in facsimil.

                                 CERTIFICAT
pentru detinerea de medicamente si substante stupefiante si psihotrope

  ________________      _______________________        ___________________(1)
  (Stat)                (Oras)                         (Data)
 ______________________________________________________________________________
| A. Medicul care a prescris:                                                  |
|______________________________________________________________________________|
|                                                                              |
| _________________________  ________________________  __________________ (2)  |
| (Nume)                     (Prenume)                 (Telefon)               |
|                                                                              |
| _______________________________________________________________________ (3)  |
| (Adresa)                                                                     |
|______________________________________________________________________________|
| B. Pacient:                                                                  |
|                                                                              |
| ___________________________ (5)  ______________________________________ (6)  |
| (Nume)         (Prenume)         (Numarul pasaportului sau actului de        |
|                                  identitate                                  |
|                                                                              |
| ___________________________ (7)  ______________________________________ (8)  |
| (Locul nasterii)                 (Data nasterii)                             |
|                                                                              |
| ___________________________ (9)  ______________________________________ (10) |
| (Nationalitate)                  (Sex)                                       |
|                                                                              |
| _______________________________________________________________________ (11) |
| (Adresa)                                                                     |
|                                                                              |
| ___________________________ (12) ______________________________________ (13) |
| (Numar de zile de calatorie)     (Valabilitatea autorizatiei - maxim         |
|                                  30 de zile                                  |
|______________________________________________________________________________|
| C. Medicament prescris:                                                      |
|                                                                              |
| ___________________________ (14) ______________________________________ (15) |
| (Denumire comerciala)            (Forma farmaceutica)                        |
|                                                                              |
| ___________________________ (16) ______________________________________ (17) |
| (Denumirea comuna                (Concentratia substantei active)            |
| internationala a substantei                                                  |
| active)                                                                      |
|                                                                              |
| ___________________________ (18) ______________________________________ (19) |
| (Instructiuni de                 (Cantitatea totala de substanta activa)     |
| administrare)                                                                |
|                                                                              |
| ___________________________ (20)                                             |
| (Numarul de zile de                                                          |
| prescriere - maxim 30 zile)                                                  |
|                                                                              |
| _______________________________________________________________________ (21) |
| (Observatii)                                                                 |
|______________________________________________________________________________|
| D. Autoritatea emitenta:                                                     |
|                                                                              |
| ___________________________ (22)                                             |
| (Denumire)                                                                   |
|                                                                              |
| ...............  .......... (23)                                             |
| (Adresa)         (Tel.)                                                      |
|                                                                              |
| ____________________________     ______________________________________ (24) |
| (Stampila)                       (Semnatura)                                 |
|______________________________________________________________________________|

 ______________________________________________________________________________
| Certification to carry drugs and/or  | Certificat pour le transport de       |
| psychotropic substances for the      | stupefiants et/ou de substances       |
| purpose of medical treatment -       | psychotropes a des fins therapeutiques|
| Article 75 of the Schengen Convention| - Article 75 de la Convention         |
|                                      | d'application de l'Accord de Schengen |
|                                      |                                       |
| (1) Country, town, date              | pays, delivre a, date                 |
|                                      |                                       |
| A. Prescribing doctor                | Medecin prescripteur                  |
|                                      |                                       |
| (2) Name, first name, tel            | nom, prenom, telephone                |
| (3) Adress                           | adresse                               |
| (4) Where issued by a doctor:        | en cas de delivrance par un medecin:  |
| doctor's stamp and signature         | cachet, signature du medecin          |
|                                      |                                       |
| B. Patient                           | Patient                               |
|                                      |                                       |
| (5) Name, first name                 | nom, prenom                           |
| (6) No of passport or other          | no du passeport ou du document        |
| identification document              | d'identite                            |
| (7) Place of birth                   | lieu de naissance                     |
| (8) Date of birth                    | date de naissance                     |
| (9) Nationality                      | nationalite                           |
| (10) Sex                             | sexe                                  |
| (11) Adress                          | adresse                               |
| (12) Duration of travel in days      | duree du voyage en jours              |
| (13) Validity of authorisation       | duree de validite de l'autorisation   |
| from/to  - maximum 30 days           | du/au - max. 30 jours                 |
|                                      |                                       |
| C. Prescribed drug                   | Medicament prescrit                   |
|                                      |                                       |
| (14) Trade name or special           | nom commercial ou preparation         |
| preparation                          | speciale                              |
| (15) Dosage form                     | forme pharmaceutique                  |
| (16) International name of active    | denomination internationale de la     |
| substance                            | substance active                      |
| (17) Concentration of active         | concentration de la substance         |
| substance                            | active                                |
| (18) Instructions for use            | mode d'emploi                         |
| (19) Total quantity of active        | quantite totale de la substance       |
| substance                            | active                                |
| (20) Duration of prescription        | duree de la prescription,             |
| in days - maximum 30 days            | en jours - max. 30 jours              |
| (21) Remarks                         | remarques                             |
|                                      |                                       |
| D. Issuing/accrediting authority     | Autorite qui delivre/authentifie      |
| (delete where not applicable)        | (bifer ce qui ne convient pas)        |
|                                      |                                       |
| (22) Name                            | designation                           |
| (23) Adress, tel                     | adresse, telephone                    |
| (24) Authority's stamp and signature | sceau, signature de l'autorite        |
|______________________________________|_______________________________________|