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OSTEOPOROSIS REFERRAL FORM Updated January 2021Patient Name Today's Date NEW Patient CURRENT Patient DOB Height Weight Male Female Preferred Language Best Phone Email Street Address Apt# City State
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How to fill out osteoporosis prescription and referral
How to fill out osteoporosis prescription and referral
01
Obtain the prescription from a licensed healthcare provider.
02
Ensure that the prescription includes all necessary information such as patient name, date, medication dosage and frequency.
03
Take the prescription to a pharmacy or medical supply store.
04
Provide the pharmacist or store representative with your prescription.
05
If necessary, ask for assistance in understanding how to properly take the medication or use any related devices.
06
Follow the instructions provided by your healthcare provider and the medication packaging.
07
Keep track of your medication usage and schedule any necessary follow-up appointments with your healthcare provider.
Who needs osteoporosis prescription and referral?
01
Individuals who have been diagnosed with osteoporosis require an osteoporosis prescription and referral. Additionally, individuals who are at high risk for developing osteoporosis, such as postmenopausal women and individuals with a family history of the disease, may also require a prescription and referral for preventative or diagnostic purposes.
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