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013-1855
Statement of Service (Form F) -
4976-47
Healthcare Provider Notification of MedsCheck ServicesUsing 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.on00180
Special or Extraordinary Expense Claim – Form FTo provide information to assist the court in the establishment or variation of a child support order when requesting that the court order the Respondent to pay a share of a child's special or extraordinary expenses.
