Get Stony Brook University Non-formulary Medication Request Form
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How to fill out the Stony Brook University Non-Formulary Medication Request Form online
This guide provides users with step-by-step instructions on how to complete the Stony Brook University Non-Formulary Medication Request Form online. Following these clear instructions will ensure that all necessary information is submitted effectively.
Follow the steps to complete the form accurately.
- Press the ‘Get Form’ button to access the Non-Formulary Medication Request Form and open it in the appropriate editor.
- Begin by pasting the patient information label in the specified area at the top of the form. This ensures that all patient details are correctly linked to the medication request.
- Fill in the 'Date of order' section with the current date. This is essential for record-keeping and tracking the medication request timeline.
- Specify the 'Name of medication' required. Ensure to include the exact name to avoid any miscommunication.
- Indicate the 'Dose' of the medication along with the 'Frequency' of administration. Both are crucial for the pharmacy to prepare the correct prescription.
- Select the 'Dosage form' (e.g., tablet, liquid) to inform the pharmacy of the type of medication needed.
- Estimate the 'Expected duration of therapy' to help pharmacists manage the supply and billing appropriately.
- Enter the 'Prescriber’s name' to identify the physician authorizing the medication. Only attending physicians may initiate therapy for non-formulary drugs.
- Provide a comprehensive 'Reason why non-formulary medication is required,' particularly if no formulary therapeutic substitution is suitable for the patient. This information is necessary for the pharmacy's assessment.
- Have the physician sign the form in the designated area and include their stamp if applicable. This validates the request and authorizes the pharmacy to act accordingly.
- Check the 'Pharmacy Use Only' section, where pharmacists may document necessary information. Users do not need to complete this section.
- Once the form is completed, save all changes, then download, print, or share the document as required. Ensure that you keep a copy for your records.
Complete the Stony Brook University Non-Formulary Medication Request Form online now to ensure your medication request is processed promptly.
Typically, non-formulary drugs may count towards your deductible, depending on your insurance plan. When you use the Stony Brook University Non-Formulary Medication Request Form, it's important to check your specific coverage details. Some plans may impose higher copays for non-formulary medications, affecting your overall deductible obligations. Understanding these terms can help you make informed decisions about your medication options.
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