Toniq templates are useful wherever a form is required, not just for LTC service requirements. Remember, they self-populate where possible and can be stored in patient history, helpful for audit and/or clinical review.


Toniq is continually adding to and revising the library of templates available for these initiatives and medicines. One of the latest, seasonally appropriate ones, is the new single-page Flu Kit Consent Form.


We are happy to look at your document and advise if we are able to convert it into a Diary Template. Word or PDF documents preferably, otherwise a scan of the form, can be sent to support@toniq.co.nz and we’ll let you know what we can do.


Available Templates


General/Med TemplatesDescription and Usage
TQ Emergency ContraceptionCheck list to print for patient to fill in, and take away. Store in patient history
TQ TMP UTI AssessmentCollege of pharmacist's patient check list to be filled in when trimethoprim supplied by pharmacist. Store in patient history – notify GP
TQ Emergency SupplyDeclaration of pharmacy supply. Store in patient history. Print and file for Audit
TQ Quitline Referral FormSimple form with patient details to fax to Quitline
TQ Silvasta/Vedafile/Sildenafil Form 1 ScreeningScreening for each of the 3 brands to determine if pharmacy supply or patient GP referral indicated
TQ Silvasta/Vedafile/Sildenafil Form 2 SupplyTemplate for each of the 3 brands with patient details and guidelines for supply. Store in patient history
TQ Form for WINZ fundingTo fund packing costs for a particular patient. Statement of patient factors and costs. Print and process Store in patient history
TQ Incident Reporting – PDA3 Page PDA based form for reporting details of an incident. Store in patient history, print, process and file
TQ Carm Form for Adverse ReactionsAdverse Reactions to Medicine, Vaccines and Devices and all clinical events for IMMP. To be faxed or posted
TQ Section 29 FormMedsafe Declaration/Notification Form for medicines supplied pursuant to Section 29 of Medicines Act 1981
TQ CDHB Stop smokingReferral form for stop smoking service ie: Te Ha Waitaha
TQ Gout formsGout prevention programme
TQ Yellow Card LandscapeEach DHB uses its own wording on their yellow card but Toniq has provided a variant as template. Edit to your DHB requirements and print to yellow paper, then print a Medicine Chart onto the other side.


CPAMS TemplatesDescription and Usage
TQ CPAM Consent FormPrint for patient to fill in. Store in patient history and file in pharmacy
TQ CPAM InvoiceForm can be used to invoice CPAM services


LTC TemplatesDescription and Usage
LTC1 to LTC8Required templates for delivery of the LTC service. Include Evaluation, Registration/Consent, Medicines Management, Annual Re-assessment. Exit & Transfer
LTC8 Transfer RequestRequest from one pharmacy to another to exit the service so the patient can be re-registered at another pharmacy
TQ Doctor LTC Info RequestRequest from pharmacy to prescriber for patient long term conditions and hospital admissions
LTC LeafletPrint for patient information. Facilitates self-evaluation and details service for patient. Store in patient history
LTC Mental Health DiagnosisFlowchart to help with evaluation of mental health condition. To decide if condition scores 10 points or 2
TQ Heart FailureChecklist for LTC patients with Heart Failure


Special Prescription Plan 
TQ Abbvie Care Pharmacy ProgrammePatient counselling monthly checklist
TQ Maviret QUMQuality use of medicines guide - Abbvie



Using patient diary templates

Select a patient, press F10 Other and Open patient diary. Press F7 Use Tmplate and select the one required.


Creating your own template

Simple templates can be made by going to:

  • 9. Other
  • 5. Edit note templates
  • then pressing F3 Add
  • Names and other details that are to be pre-populated can be entered using options under F3 Patient field and F4 Other field
  • the document can be formatted using the function keys


Word documents can be imported and then added-to, as long as they are saved as an rtf file. (within Word, press Save as and select Rich Text Format from the drop-down box below the file name as shown). 

From within Edit note templates, press F10 Other and choose 2 Load from RTF file to import the document into Toniq.