Get Express Scripts Fax Form

Completing the Express Scripts Fax Form online is a straightforward process that allows users to efficiently submit their prescriptions. By following this guide, you can ensure all necessary information is accurately filled out to facilitate the timely processing of your order.

Follow the steps to complete the Express Scripts Fax Form online.

1. Press the ‘Get Form’ button to access the Express Scripts Fax Form and open it for editing.
2. In the ‘Patient’ section, fill in all required details including your member ID, first name, last name, address, date of birth, and phone number. This information is crucial for identifying the prescription.
3. Navigate to the ‘Doctor/Prescriber’ section and include the doctor’s information, such as their name, address, phone number, and fax number. Ensure the DEA number is provided if applicable.
4. In the ‘Patient Options’ section, indicate any preferences regarding medication packaging or labels, and check the box if you require rush delivery.
5. Fill in the ‘Allergies’ and ‘Health Conditions’ sections with relevant information. This helps the pharmacy understand your medical history and avoid potential issues.
6. Under the ‘Over-the-Counter Medications’ section, list any non-prescription medications you are taking along with their expiration date.
7. In the ‘Rx’ section, enter the prescribed medication details including the first name and last name of the prescribing doctor, drug name, form, strength, quantity, directions for use, and the number of refills.
8. Obtain the doctor’s signature for permission to fill the prescription. They should sign in the designated area for 'Substitution Permissible' or 'Dispense as Written'.
9. After all fields are completed, review the form for accuracy. Once verified, you can save changes, download, print, or share the completed form as required.

Complete your documents online for a streamlined prescription process.