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Get Contact Lens Rx Template
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How to fill out the Contact Lens Rx Template online
Filling out the Contact Lens Rx Template online is a straightforward process that allows users to transfer their existing maintenance prescriptions to a new pharmacy. This guide will provide step-by-step instructions on each section of the form to ensure a smooth and efficient submission.
Follow the steps to complete your Contact Lens Rx Template effectively.
- Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
- Begin by entering your personal details for prescription #1. Fill in your name, date of birth, and phone number in the required fields marked with an asterisk (*).
- Next, provide the prescription number and the number of refills remaining. You can also include your email address for any follow-up communication.
- Indicate the name of the medication and the date it was last filled. Ensure that you enter the name of the pharmacy where it was last filled as well.
- Input your prescribing doctor's name, telephone number, and, if available, their fax number.
- Finally, sign the form to confirm your request for the prescription transfer.
- Repeat steps 2 to 6 for any additional prescriptions you need to transfer, as there are places for up to four prescriptions on the form.
- Review all entered information for accuracy before finalizing your submission.
- Once you have completed the form, options for submission include faxing to (406) 869-6552, emailing to miRx@ebms.com, or mailing to PO BOX 21669, Billings, MT 59104.
Start filling out your Contact Lens Rx Template online to facilitate your prescription transfer today!
1-800 Contacts Online Prescriptions is the most convenient way in the whole world to renew your contact lens prescription. All you need is 10-15 minutes, your computer and/or a smartphone. Within a business day you'll have a valid, doctor-approved contact lens prescription guaranteed.
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