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Phone 877.291.1122 Fax 877.291.1155 4010 Wedge way Court Earth City, MO 63045Patient Insurance Information Please Attach to Patient Prescription to 877.291.1155 Please attach a copy of insurance card
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To fill out an FC - prescription order, follow these steps:
02
Start by writing the date on the top right corner of the order form.
03
Next, provide your personal information, including your name, address, and contact details.
04
Indicate the name of the medication you need in the designated field.
05
Specify the dosage requirements, such as the strength and quantity of the medication.
06
Include any additional instructions or special requests, if necessary.
07
If you have a preferred pharmacy, mention its name and contact information.
08
Finally, sign the order form at the bottom to validate it.
09
Remember to double-check all the information before submitting the FC - prescription order.

Who needs fc - prescription order?

01
Anyone who requires medication can utilize an FC - prescription order.
02
This form is typically used by patients who need to get prescription drugs from a specific pharmacy.
03
It is especially useful for individuals who have ongoing prescriptions and want to conveniently reorder their medications.
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FC - prescription order refers to a controlled substance prescription that is subject to specific federal and state regulations for the prescribing and dispensing of narcotics and other regulated drugs.
Healthcare providers who prescribe controlled substances, such as physicians, dentists, and certain other licensed practitioners, are required to file an FC - prescription order.
To fill out an FC - prescription order, practitioners must include the patient's full name, address, the date of the prescription, the name and quantity of the drug, dosage instructions, and their own DEA registration number.
The purpose of the FC - prescription order is to regulate the prescribing and dispensing of controlled substances, ensuring that these medications are used safely and appropriately.
Information that must be reported includes the patient's identification details, the prescribed drug's name and strength, dosage instructions, quantity, and the prescriber's information including their license number.
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