Personal Medication Record
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Forms, Links, and Information
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English - 4968-47e - Personal Medication RecordPDF
Using the standardized fax template, pharmacists must share the completed...
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French - 4968-47f - Personal Medication RecordPDF
Additional Information
Form Number | 4968-47 |
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Title | Personal Medication Record |
Description | Using the standardized fax template, pharmacists must share the completed MedsCheck Personal Medication Record with the patient's primary prescriber. A record of the successfully transmitted fax must be kept on file at the pharmacy. |