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MED-PASS:  The Fine Art of Document Design

Prescriber Fax Notification Form - 100/pad


Availability: In stock

Price: $10.75
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Finally, an efficient way to notify a resident‘s Prescriber and receive order changes promptly.

According to community policy, this form can be completed by designated staff, then faxed to the prescriber.

Upon receiving the prescriber‘s reply, the designated community staff can complete the bottom of the form and forward the signed prescription/order change to the pharmacy.
  • Routing bar code added for electronic document management utilizing the Integra DocuTrack system
Size 8-1/2 x 11
Unit Pad of 100
Other Info Handwritten
Hole Punch 5 holes left, 5 holes top

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