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Johns Hopkins Outpatient Pharmacy Autofill and Prescription Delivery Enrollment Form for Johns Hopkins Employees Please complete the entire form for each patient enrolling in the delivery service:

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How to fill out automatic refill and prescription

01

Contact your pharmacy to enroll in their automatic refill program.

02

Provide your prescription information, including medication name, dosage, and quantity.

03

Confirm your preferred location for pick-up or delivery of refilled prescriptions.

04

Set up a payment method for automatic refills, if required.

05

Review and sign any necessary consent forms or agreements for the program.

Who needs automatic refill and prescription?

01

Individuals who have chronic conditions and require ongoing medication management.

02

Patients who have difficulty remembering to refill their prescriptions on time.

03

Caregivers responsible for managing medication for a loved one.

04

Busy individuals who prefer the convenience of having prescriptions automatically refilled.

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What is automatic refill and prescription?

Automatic refill is a service offered by pharmacies that allows the refill of prescriptions without the need for the patient to manually request it each time. Prescription is a written order from a healthcare provider to a pharmacist to dispense a specific medication to a specific patient.

Who is required to file automatic refill and prescription?

Patients who have ongoing medication needs and healthcare providers who prescribe medications are required to utilize automatic refill and prescription services.

How to fill out automatic refill and prescription?

Automatic refills are typically set up through the patient's pharmacy or healthcare provider, with the patient providing consent for automatic refills. Prescriptions are filled out by healthcare providers and sent to the pharmacy electronically or via paper.

What is the purpose of automatic refill and prescription?

The purpose of automatic refill and prescription is to ensure patients have a continuous supply of medication without the need for manual intervention for each refill. This helps improve medication adherence and overall health outcomes.

What information must be reported on automatic refill and prescription?

Automatic refill information may include patient name, medication name, refill frequency, and pharmacy information. Prescription information includes the patient's name, medication name, dosage, and instructions for use.

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