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Get the free THMP Extra Medication Request Form Fax to 512-533-3171 If you ...

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TEMP Temporary Out of State or Extra Medication Request Form Fax to 5125333171 If you need an early or extended supply of medications, please fill out this form and fax to the number above. TEMP can
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How to fill out thmp extra medication request

01
To fill out a THMP Extra Medication Request form, follow these steps:
02
Obtain the THMP Extra Medication Request form from your healthcare provider or local pharmacy.
03
Fill in your personal information, including your name, address, and contact details.
04
Provide details about the medication you are requesting, such as the name, strength, and dosage.
05
Indicate the reason for the request, explaining why you need the extra medication.
06
If applicable, provide any supporting documentation or medical records to justify the request.
07
Review the form and ensure all information is accurate and complete.
08
Sign and date the form.
09
Submit the completed form to your healthcare provider or local pharmacy as instructed.

Who needs thmp extra medication request?

01
THMP Extra Medication Request forms are typically needed by individuals who are enrolled in the Texas HIV Medication Program (THMP) and require additional or extra medication beyond their regular prescription.
02
This may include individuals who have experienced a change in their medical condition, need additional medication for travel purposes, or require emergency supplies.
03
The exact eligibility and requirements for the THMP Extra Medication Request may vary, so it is best to consult with your healthcare provider or THMP representative for specific guidance.
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THMP Extra Medication Request is a form used to request additional medication through the Texas HIV Medication Program (THMP) beyond the regular medication allocation.
Patients who are enrolled in the Texas HIV Medication Program (THMP) and require more medication than their regular allocation may be required to file a THMP Extra Medication Request.
To fill out a THMP Extra Medication Request, patients must provide their personal information, medical history, details about their current medication regimen, and reasons for needing additional medication.
The purpose of a THMP Extra Medication Request is to ensure that patients enrolled in the Texas HIV Medication Program (THMP) receive the necessary additional medication beyond their regular allocation.
Patients must report their personal information, medical history, current medication regimen, and reasons for needing additional medication on the THMP Extra Medication Request form.
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