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SIGN AND FAX THIS FORM TO 877.828.3939 If you have questions, please call 877.627.MEDS (6337) Prime Specialty Pharmacy NPI: 1457618555 HIV REFERRAL FORM PRESCRIPTION INFORMATION First Name: Deliver
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01
Gather all necessary documents: Make sure you have all the required paperwork that needs to be filled out, signed, and faxed. This may include forms, agreements, contracts, or any other relevant documents.
02
Read the instructions: Take the time to carefully read through the instructions provided with the document. This will ensure that you understand the process and any specific requirements for filling out and signing the document.
03
Fill out the document: Use a pen or type directly into the document if it is an editable digital form. Provide all the requested information accurately and completely. Review the document before moving on to the next step to ensure you haven't missed anything.
04
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Make a copy (optional): It is always a good idea to make a copy of the completed document for your records. This will serve as proof of what was sent and received if needed in the future.
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Prepare for faxing: If you have a physical copy of the document, ensure that it is ready for faxing. Remove any staples, paperclips, or other obstructions that may affect the quality of the fax.
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Use a fax machine or online faxing service: If you have access to a fax machine, follow the instructions provided with the machine to send the document. Alternatively, you can use an online faxing service that allows you to upload the document digitally and send it to the recipient's fax number.

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01
Individuals: Anyone who needs to provide a signature on a document and send it to someone else may need to fill out, sign, and fax the document. This includes individuals signing contracts, agreements, or other legal documents.
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Businesses: Businesses may need to sign and fax documents as part of their regular operations. This could involve contracts with clients, vendor agreements, or other important paperwork.
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Professionals: Various professionals, such as lawyers, doctors, or financial advisors, may need to fill out and sign documents to fulfill legal or regulatory requirements. These professionals often deal with sensitive information and need to maintain appropriate documentation.
In summary, anyone who needs to provide a signature on a document and send it to another party may need to fill out, sign, and fax the document. It is important to carefully follow the instructions provided with the document and ensure that all necessary steps are completed accurately.
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