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Thank you for answering the following questions completely and accurately. General Medical History Are you under a physician s care now Yes No If Yes Please Explain Have you ever had a serious head/neck injury Are you taking any medications/pills/drugs If Yes Please List Have you been hospitalized or had a major operation Have you taken or do you take Phen-Fen or Redux Are you on a special diet Do you use tobacco products For How Long packs/day Do you use controlled substances For Women Are...
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To fill out the preferred pharmacy address zip, follow these steps:
02
Begin by visiting the preferred pharmacy address section of the form.
03
Locate the field designated for the zip code.
04
Enter the correct zip code for your preferred pharmacy address.
05
Double-check the entered zip code to ensure accuracy.
06
Once you have entered the correct zip code, proceed to complete the rest of the form as required.

Who needs preferred pharmacy address zip?

01
Preferred pharmacy address zip is needed by individuals who:
02
- Want to specify their preferred pharmacy for prescription fulfillments.
03
- Need their medications to be sent directly to a specific pharmacy for convenience.
04
- Wish to ensure that their preferred pharmacy receives all necessary information for prescription refills.
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