Get Nm Needle And Syringe Order Form 2018-2025
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How to fill out the NM Needle and Syringe Order Form online
Filling out the NM Needle and Syringe Order Form online can be a straightforward process with the right guidance. This guide provides step-by-step instructions to help you accurately complete the form and submit it for processing.
Follow the steps to complete your order form successfully.
- Click the ‘Get Form’ button to access the form and open it in your preferred space for editing.
- Fill in the required fields including SBHC/School Name, Address, City, State Zip, Email, VFC Pin#, Date submitted, Phone #, and Fax #. Ensure all fields marked with an asterisk (*) are completed to process your order.
- Specify the number of boxes you are requesting for the Vanish Point® 3ml Syringe with Needle in the designated field.
- If you require needles only, indicate the number of boxes for each type of needle requested, remembering that the warehouse will fill requests based on their available inventory.
- For E-Kit Medications, input the quantity ordered for Diphenhydramine and Epinephrine in their respective fields.
- Complete the section titled 'PLEASE COMPLETE THIS SECTION' by entering the printed name, date, and providing your signature for verification.
- Once the form is accurately filled, the next steps involve faxing the completed document to 505-424-3438 or emailing it to DOH-PharmacyOrders@state.nm.us for processing.
- After submission, the Pharmacy Warehouse will contact you regarding delivery information. Ensure to save changes, download, or print a copy of the form for your records.
Start filling out the NM Needle and Syringe Order Form online today to ensure your order is processed efficiently.
Syringe service programs, or SSPs, provide critical services to individuals who use injection drugs. These programs aim to reduce the spread of infectious diseases by offering sterile syringes and safe disposal options. Through the NM Needle and Syringe Order Form, you can easily access the supplies needed to support public health efforts. Engaging with an SSP also enhances access to healthcare services, helping individuals receive the support they need.
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