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AURELIA PRESCRIPTION START FORMER PATIENT WILL BE CONTACTED BY PANTHERxWhen Using AURELIA As A Phosphate Binder In Adult Patients With CKD On Dialysis Fax completed form to Panther at: 18552463986
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How to fill out auryxia prescription start form

01
Start by obtaining the auryxia prescription start form from your healthcare provider.
02
Fill out the patient's personal information section, including their name, date of birth, and contact information.
03
Provide the details of the healthcare provider who is prescribing auryxia, including their name, address, and contact information.
04
Indicate the start date of the prescription and the duration of treatment.
05
Specify the dosage and frequency of auryxia medication as prescribed by the healthcare provider.
06
Answer any additional questions or provide any necessary information as per the form's instructions.
07
Review the filled form carefully to ensure accuracy and completeness.
08
Sign and date the form.
09
Submit the completed auryxia prescription start form to your healthcare provider or the designated recipient.

Who needs auryxia prescription start form?

01
Patients who have been prescribed auryxia medication require the auryxia prescription start form.
02
This form is necessary for both new patients starting auryxia treatment and existing patients requiring a new prescription.
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The auryxia prescription start form is a document used to begin the prescription process for auryxia medication.
Healthcare providers are required to file the auryxia prescription start form for their patients.
The auryxia prescription start form can be filled out by providing patient information, medical history, and prescribing details.
The purpose of the auryxia prescription start form is to initiate the prescription process for auryxia medication.
Patient demographics, medical history, prescribing healthcare provider information, and dosage details must be reported on the auryxia prescription start form.
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