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Ion Care No Known Allergies Concurrent Medications Dispense as written PRESCRIBER Print Date Substitution permitted PRESCRIBER Print Date I appoint Pharming Healthcare, Inc., RUCONEST SOLUTIONS, its affiliates, and their representatives on my behalf to convey this prescription described herein to the dispensing pharmacy. I understand that I may not delegate signature authority. 6. Optional Prescription for Bridge to Therapy Program for RUCONEST Patient Name Dispen.

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