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Prescription and Patient Support Enrollment FormTMHCPs can go to PfizerDermatologyHCPPortal.com to complete this form online. Questions? Call 18339563376, Monday Friday, 8:00 am to 8:00 pm ET. Fax

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How to fill out prescription and patient support

01

Gather all necessary information about the patient including name, date of birth, address, and insurance information.

02

Write the prescription including the medication name, strength, dosage instructions, and quantity.

03

Include your DEA number and signature on the prescription.

04

Provide clear instructions for the patient on how to take the medication, any potential side effects, and when to follow up with a healthcare provider.

05

Offer patient support by answering any questions or concerns they may have about the medication or treatment plan.

Who needs prescription and patient support?

01

Patients who have been prescribed medication by a healthcare provider.

02

Patients who may have questions or need additional support regarding their medication or treatment plan.

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What is prescription and patient support?

Prescription and patient support refers to the assistance and guidance provided to patients in managing their medications as prescribed by a healthcare provider.

Who is required to file prescription and patient support?

Healthcare providers, pharmacists, and medical staff are required to file prescription and patient support.

How to fill out prescription and patient support?

Prescription and patient support can be filled out by documenting the medication regimen, dosage instructions, and any necessary follow-up care.

What is the purpose of prescription and patient support?

The purpose of prescription and patient support is to ensure that patients understand and adhere to their prescribed medication regimen for optimal health outcomes.

What information must be reported on prescription and patient support?

Information such as medication name, dosage, frequency, administration instructions, and any potential side effects must be reported on prescription and patient support.

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