Follow the steps to fill out your Olympia Pharmacy Prescription Order:

1. Click ‘Get Form’ button to obtain the form and open it in an editor.
2. Enter your account number in the designated field at the top of the form. This helps in managing and tracking your prescription orders.
3. In the section labeled 'MUST CHECK ONE', choose how you would like to receive tracking updates by selecting either 'Email tracking to:' or 'Fax: 407-673-1234'.
4. Indicate whether the entire cost will be billed to the physician or the patient by checking the appropriate box; also, mark if this is a refill.
5. Fill in the 'Account Open Date' along with the clinic or physician name and their phone number.
6. Complete the address section, including the city, state, and ZIP code.
7. Choose your preferred shipping method by checking one of the options: Ground, 2nd Day, or Overnight.
8. Provide the patient's information by filling in their name, date of birth, address, city, phone number, state, ZIP code, and email.
9. In the section labeled 'MUST CHECK ONE', select whether the patient will pick up at the pharmacy or if items need to be shipped to the patient or office address.
10. Fill out the necessary medication information including the desired medication type and required quantities, indicated by various codes such as PGE1, NB-143, etc.
11. If applicable, specify if reversal medication is needed in case of priapism and include the relevant details.
12. Indicate the number of syringes or bags needed along with additional items like alcohol swabs.
13. Provide the signature of the physician, along with their printed name, NPI number, phone, and any refills required.
14. Ensure that the date field is completed before finalizing the form.
15. Review all the entered information for accuracy. Save changes, download, print, or share the completed form as necessary.

Complete your Olympia Pharmacy Prescription Order online today for a seamless experience.