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Phone: 7852968163 Fax: 7852968059 Hackett ks.gov www.kdheks.gov/idp/ Bureau of Health Promotion 1000 SW Jackson Ave, Suite 230 Topeka, KS 66612 IMMEDIATE RELEASE May 4, 2016, Contact: Cassie Sparks
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How to fill out prescription drug release form:

01
Begin by obtaining the prescription drug release form from your healthcare provider or pharmacist. This form is usually required when you need to transfer your prescription from one pharmacy to another or when you need to authorize someone else to pick up your medication on your behalf.
02
Fill in your personal information accurately. This usually includes your full name, date of birth, address, and contact information. Make sure to write legibly and double-check for any errors or incorrect spellings.
03
Provide the details of the prescription. This includes the name of the medication, dosage instructions, and the prescribing healthcare professional's information. If you're transferring a prescription, ensure you accurately enter the current pharmacy's name and contact information as well.
04
Indicate any specific instructions or additional information. If there are any special requirements or considerations related to your medication, such as the need for refrigeration or certain administration instructions, make sure to include them in the appropriate section of the form.
05
Review the form thoroughly before signing. Before signing the prescription drug release form, carefully read through all the information you've provided to ensure its accuracy. Any mistakes or missing details could lead to issues with transferring or receiving your medication.

Who needs prescription drug release forms:

01
Patients who need to transfer their prescription from one pharmacy to another. This could be due to convenience, insurance coverage changes, or a preferred pharmacy change.
02
Patients who are unable to pick up their medication personally and need someone else to do it on their behalf. This could be due to illness, disability, or other constraints.
03
Patients who require specialized medication or treatments that may only be available at specific pharmacies. In such cases, the prescription drug release form may be necessary to ensure continuity of care.
Remember, it's essential to follow the specific guidelines provided by your healthcare provider or pharmacist when filling out a prescription drug release form. If you have any doubts or questions, don't hesitate to seek clarification from a healthcare professional.
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Prescription drug release forms are obtained from pharmacies or medical facilities.
Healthcare providers are required to file prescription drug release forms.
Prescription drug release forms must be filled out with the patient's information, prescribed medication, dosage instructions, and healthcare provider details.
The purpose of prescription drug release forms is to ensure that patients receive the correct medication and dosage prescribed by their healthcare provider.
Information such as patient's name, medication name, dosage, frequency, and healthcare provider's details must be reported on prescription drug release forms.
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