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1PATIENT INFORMATION Patient Name: Phone: Address: City:___State:___Zip:___ MRN #: DOB: Drug Allergies:Kaiser Permanente Washington Home Infusion Pharmacy (KPWAHIP) () Prescription Referral Form Phone:
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Gather all relevant information and documentation such as prescription details, insurance information, and personal information.
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Contact the pharmacy either in person, on the phone, or through their website or app.
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Who needs pharmacy services in washington?

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Anyone in Washington who requires prescription medication or over-the-counter drugs needs pharmacy services.
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Patients who need specialized medications or medical equipment can benefit from pharmacy services in Washington.
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Pharmacy services in Washington refer to the various healthcare services provided by licensed pharmacists and pharmacies, including medication dispensing, patient counseling, health screenings, and medication management.
Licensed pharmacies and pharmacists providing services to patients are required to file pharmacy services in Washington.
Pharmacy services should be filled out using the official forms provided by the Washington State Department of Health, ensuring all required information is accurately completed and submitted by the appropriate deadline.
The purpose of pharmacy services in Washington is to ensure safe and effective medication use, promote public health, and comply with state regulations governing pharmacy practice.
Information that must be reported includes details about drug dispensing, medication errors, adverse drug reactions, and the number of patients served.
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