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DATE STAMP03/16/2023Electronic Prescription Medication Consent Form Patient Name: ___ DOB: ___ Finger Lakes Community Health uses an electronic medical record system that allows electronic prescribing
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How to fill out electronic prescription medication consent

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Access the electronic prescription medication consent form online
02
Fill in your personal information such as name, date of birth, and address
03
Provide information about your medical history and list any current medications you are taking
04
Review the consent form carefully to ensure all information is accurate
05
Sign and date the form electronically to complete the process

Who needs electronic prescription medication consent?

01
Individuals who are receiving electronic prescriptions for medication from their healthcare providers
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Electronic prescription medication consent is the authorization given by a patient to allow healthcare providers to electronically prescribe and dispense medication.
Patients who wish to receive medication prescriptions electronically are required to file electronic prescription medication consent.
Electronic prescription medication consent can usually be filled out electronically through a patient portal or by signing a paper form provided by the healthcare provider.
The purpose of electronic prescription medication consent is to streamline the medication prescription and dispensing process, making it more efficient and convenient for both patients and healthcare providers.
Electronic prescription medication consent typically includes the patient's name, contact information, medication allergies, and any specific instructions or preferences regarding their medication.
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