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For clarifications to this BPMH see updated BPMH form Chart Copy Do Not Destroy Place in Physician Order Section DO NOT THIN FROM CHART ORD37 Faxed to Pharmacy Yes or No Page 1 of 1 Date Faxed ddmmyyyy. BEST POSSIBLE MEDICATION HISTORY BPMH RECONCILIATION PRESCRIBER ORDER FORM ALLERGIES describe reaction INTOLERANCES describe reaction MAR Change Hold xh/2 yzx Discontinue Route Include Prescription and regularly taken OTC PRN vitamin herbal Dose Medication Name Continue PHYSICIAN /...

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