Get Sti Medication Order Form - City Of Toronto

Filling out the STI Medication Order Form for the City of Toronto online is a straightforward process. This guide will help you navigate through each section and field to ensure you complete the form accurately and efficiently.

Follow the steps to fill out the form correctly.

1. Click 'Get Form' button to access the STI Medication Order Form and open it in your selected editor.
2. In the 'Ordering Health Care Provider Information' section, fill in the name of the health care provider or clinic, the contact person's printed name, and the date of your request.
3. Indicate the hours of operation for the clinic, including if you are closed for lunch. Specify the closed hours if applicable.
4. For the medication requested, check the appropriate first-line treatment for gonorrhea, which is 250 mg IM plus 1 g, allowing time for delivery.
5. If applicable, provide the client's name, date of birth, and complete the ' Order' section.
6. In the 'TPH Office Use Only' section, leave spaces for user identification such as IPHIS #, staging details, and the authorizing Public Health Nurse's name.
7. Finally, ensure the recipient's signature, the date approved in the format YYYY/MM/DD, and the date received are properly filled out.
8. Once you are satisfied with the form details, save any changes and download, print, or share the form as needed.

Complete your STI Medication Order Form online today for accurate and timely processing.