Handle a prescription you are not going to dispense — the professional judgement recorded, the patient conversation, the prescriber contact, and the continuity of care that stops a refusal becoming abandonment. Use when asked how to refuse to fill a prescription, decline to dispense, handle a suspected forgery or early refill, or document a corresponding-responsibility decision. Produces the decision record, the conversation script, the prescriber contact, the continuity step, and the escalation path. Legal obligations vary by jurisdiction; verify yours.
“How do I refuse to fill this prescription properly?”“I think this prescription is forged — what do I do?”“Patient is asking for an early refill on a controlled drug”“How do I document a decision not to dispense?”“What do I say to the patient when I decline?”
What to give it
▸The prescription and the concern — what was presented and what specifically prompted the decision
▸What you checked — prescriber verification, dispensing history, monitoring programme if available, and what each showed
▸The patient interaction so far — what they said, and whether they have been told anything yet
▸The clinical picture — legitimate therapeutic need, whether abrupt discontinuation carries risk, and any known dependency
▸Your obligations — your jurisdiction's rules on refusal, referral, transfer, and reporting, which vary substantially
✅ The bar it holds itself to
Every skill in this library self-verifies — these are this skill's own quality checks, straight from its definition.
✓The concern is recorded as an observation, not as a characterisation of the patient
✓Verification with the prescriber was attempted before declining, where possible
✓The conversation happened somewhere the patient could not be overheard
✓The wording owns the decision rather than accusing the patient
✓Risk from abrupt discontinuation was considered and is recorded
✓The patient was given a specific next step
✓Escalation, if any, went down the correct path with a stated basis
⚠️ What it refuses to do
**Declining in front of a queue.** Even a correct decision becomes a complaint and a humiliation.
**Recording a suspicion as a fact.** 'Appeared to be seeking' is unsupportable and will be read back to you.
**Refusing without verifying.** The prescriber call resolves many of these and protects the rest.
**Ignoring discontinuation risk.** Some refusals create a genuine clinical emergency; that has to be part of the decision.
**No next step.** A patient sent away with nothing is the version of this that causes harm.
Install
npx pm-claude-skills add --agent claude # or codex · cursor · gemini · hermes
# or one-line MCP (every skill, any client):
claude mcp add pm-skills -- npx -y pm-claude-skills-mcp