Get Merck Abandoned Unit Return Program

Completing the Merck Abandoned Unit Return Program form efficiently is vital for health care providers looking to return abandoned units. This guide provides a detailed, step-by-step approach to successfully navigating the online form, ensuring clarity and precision in every section.

Follow the steps to complete the return form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill out the prescriber information section. Ensure that you enter the last name, first name, DEA number, NPI number, complete address (including city, state, and ZIP), office contact details, phone number, and fax number accurately.
3. Proceed to the patient information section. Provide the patient's last name, first name, complete address (including city, state, and ZIP), phone number, and date of birth.
4. In the prescription label information section, include the prescription number, pharmacy name, city, product LOT number, fill date on the prescription label, and the pharmacy address, including state and ZIP.
5. Review the attestation statements carefully. Only if you can affirm these conditions should you proceed. This includes confirming authorization to submit the form and that the information is accurate.
6. Print the form for signature. The health care provider must sign and date the form at the designated locations.
7. Submit the completed form to the original dispensing pharmacy via fax, using the appropriate fax number provided (Caremark or Accredo) for your submission.
8. If approved for return, await contact from TeleRx, Merck's third-party processor, for further return and shipping instructions.

Complete the Merck Abandoned Unit Return Program form online today to ensure effective processing of your return.