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  • Patient Profile Request Auth Form - Giant

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Pharmacy and Health-Related Services: Patient Profile Request Authorization Form This form should be used by the patient or his/her Personal Representative to request printouts of the patient s prescription.

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PS-HK-Winter 05. PS-HK-Winter 05 Pediatric Care Issues In Pediatric Care Huntsman Cancer Institute George S - Intermountainhealthcare Number 03-27 Effective Date March 15, 1993 Revised Page 1 Of 11 - Medicalcenter Osu Genetics Researchers Have Unveiled A Powerful New Resource For Scientists And Health Providers

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You can take a prescription to the pharmacy to collect someone else's medicine for them. The patient must complete part 1 of the prescription form (FP10) and the person collecting the medicine must complete parts 2 and 3.

Anyone can collect a medicine on your behalf as long as you have given consent or asked them to collect it. The person collecting your medicine should sign the back of the prescription form. They'll be asked to confirm some of your details, including your name, address and date of birth.

Can someone else pick up my prescription at CVS? Yes someone else can fill your prescription at CVS, they will just need the name and birthdate of the person who the prescription is for and usually some knowledge of their insurance cover.

The prescription profile may not be picked up by any other person except the requesting customer without the receipt of an Authorization to Release Prescription Profile (see below form) signed by the requesting customer and authorizing the release of the prescription profile to the person picking it up at the Pharmacy.

Can I have another person pick up my prescription drugs, medical supplies, or x-rays? Yes. HIPAA allows health care providers (such as pharmacists) to give prescription drugs, medical supplies, X-rays, and other health care items to a family member, friend, or other person you send to pick them up.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232