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New Prescription YOUR PATIENT WOULD LIKE TO RECEIVE THEIR PRESCRIPTION MEDICATION BY MAIL. 34202 Please complete ALL information below. Prescriber Information STEP 1 Questions? Call 888.327.9791 Note
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Start by gathering all necessary information such as the patient's full name, date of birth, and contact information.
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Specify the quantity of medication needed, including the number of refills if applicable.
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