CDU Short Date Reporting

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Report any CDU 340B or EPT STD medications, TB syringes, and UNOPENED TB serum here three months before the expiration date if your location will not use the supply prior to the expiration date.

CDU may contact you regarding the supply your location reports here.

If CDU requests Short Date stock to be be returned to CDU, associated postage fees can be invoiced to CDU for reimbursement.

If the name of the facility does not appear below please email cdusupplies@wyo.gov.

Email *

Location: If your location does not appear in this list email cdusupplies@wyo.gov *

Short Dated Item #1

Short date item #1 lot number

Short date item #1 expiration date - If month and year only, use last day of that month for day.

YYYY

NDC number

Quantity Item #1 (bottle/vial/Tubex/box)

Short Dated Item #2

Short date item #2 lot number

Short date item #2 expiration date - If month and year only, use last day of that month for day.

YYYY

NDC number

Quantity Item #2 (bottle/vial/Tubex/box)

Short Dated Item #3

Short date item #3 lot number

Short date item #3 expiration date - If month and year only, use last day of that month for day.

YYYY

NDC number

Quantity Item #3 (bottle/vial/Tubex/box)

Short Dated Item #4

Short date item #4 lot number

Short date item #4 expiration date - If month and year only, use last day of that month for day.

YYYY

NDC number

Quantity Item #4 (bottle/vial/Tubex/box)

Your Name *

Your contact phone number *

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