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How to fill out the Fillagreing online
Filling out the Fillagreing online can streamline your experience in managing prescriptions and membership information. This guide provides clear, step-by-step instructions to help you accurately complete the form with confidence.
Follow the steps to properly complete your Fillagreing form.
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Begin with the Member Info section. Fill in your Member ID and Group Number. Provide your date of birth in the MM DD YYYY format, followed by your last name, first name, and middle initial. Select your gender by marking 'M' or 'F'.
- Complete the Home Address section by entering your address in Address Line 1 and, if applicable, Address Line 2. Next, fill in your city, state, and ZIP+4 code. Don’t forget to provide your cell phone and home phone numbers.
- If your shipping address is different from your home address, fill in the Shipping Address section similarly to the home address section.
- Input your Government ID number, which may be necessary for controlled substances. Acceptable forms include a driver's license or military ID.
- In the Allergy Information section, select any allergies you have. If you have none, mark the 'None' option.
- Indicate any health conditions in the Health Conditions section, selecting options as they apply to you.
- Specify your order preference, choosing between easy open caps or Spanish vial labels. Then select your shipment preference, choosing from regular delivery, second business day, or next business day.
- Gather your prescription information. Attach the prescription slip from your provider to your order form. If needed, ask your provider to fax the prescription directly.
- In the Payment Information section, provide your credit or debit card details, including the card number, expiration date, and your name as it appears on the card. Remember to sign and date the form.
- Ensure that all required sections are completed and then send your form, along with your prescription and payment, using the enclosed postage-paid envelope or mail it to the designated address.
Complete your Fillagreing form online today for a seamless prescription experience.
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