To prescribe one of the hundreds of medications we dispense, but don’t have a form for, fax your local branch or find them in your e-prescribe system.

New Referral Check List – When an Order Form is not available

• An Order with:
  • Drug
  • Dose
  • Rate
  • Frequency
  • Stop Date
• Patient name and Demographics
• Insurance Information
• Medical History and Physical (H&P)
• Recent Labs
• IV Line Access