Get Abandoned Unit Form

Completing the Abandoned Unit Form is a crucial step for healthcare providers looking to return unopened units of . This guide will provide you with a clear, step-by-step approach to ensuring that you fill out the form accurately and effectively.

Follow the steps to fill out the Abandoned Unit Form online.

1. Click the ‘Get Form’ button to access the Abandoned Unit Form and open it in your preferred editing tool.
2. Begin by filling out the prescriber information section. Include your last name, first name, DEA number, NPI number, address, city, state, ZIP code, phone number, email, and fax number. Ensure all information is accurate and legible.
3. Next, move to the patient information section. Here, you will need to provide the patient's last name, first name, date of birth, phone number, and address. This information must match the prescription label.
4. In the prescription label information section, enter the prescription number, pharmacy name, pharmacy address, and fill date shown on the prescription label. Remember, a separate form is needed for each abandoned unit.
5. After completing all relevant sections, the healthcare provider must sign and date the form, attesting to the conditions specified regarding the return of the unit.
6. Once you have filled out the form in its entirety, save your changes and prepare to submit it. You can either print the form for faxing to CVS Caremark or electronically share it if applicable.

Complete the Abandoned Unit Form online today to streamline the return process for unopened units.