Get Complete The Order Form -

Filling out the Complete The Order Form online can be a straightforward process if you follow the correct steps. This guide aims to provide you with clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete the order form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the 'Date' field at the top of the form, indicating the current date of your order.
3. Enter the 'To' field with the details of the Accredo Wholesale Team, ensuring you include the contact number.
4. Provide your own contact 'From' information, including your name and phone number.
5. In the 'Customer number' section, write down your assigned customer number for accurate processing.
6. Complete the 'Purchase order number', 'Delivery date', and 'Delivery time' sections as these are essential for your order.
7. Choose the option for delivery next business day if applicable, and provide additional explanations in the designated space.
8. Fill in the 'Institution ship to' and 'Institution bill to' sections with the respective names and addresses, including street addresses, cities, states, and zip codes.
9. Specify the number of 5-packs needed and number of patients that will use them in the appropriate fields.
10. Indicate if the order is for inpatient or outpatient use and whether PHS/340b applies, including any necessary ID.
11. Provide patient information for up to three patients, including status (new or existing), age group, and gender.
12. Include the name of the prescriber and any special instructions regarding hours of operation.
13. If you wish to receive confirmation, provide your fax number and/or email address in the designated area.
14. Sign the form where indicated, providing the name, title, and date to authorize the request for fulfillment of the purchase order.
15. Once you have completed all fields, save your changes, and download, print, or share the form as needed.

Start filling out the Complete The Order Form online today to ensure your order is processed smoothly.