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How to use or fill out 2023 CarePlus Over-the-Counter (OTC) Products Mail-Order Form with DocHub
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Click ‘Get Form’ to open the 2023 CarePlus Over-the-Counter (OTC) Products Mail-Order Form in our editor.
Begin by completing your personal information in Step 1. Fill in your Member ID, name, date of birth, gender, address, and phone number. If you have a new address, check the corresponding box.
In Step 2, select the month for which you want to receive your order. Enter the quantity and product code for each item you wish to order from the catalog provided.
Proceed to calculate your total order amount. If it exceeds your allowance, include payment details in Step 3. You can pay via check or credit card.
Finally, send the completed form along with any payment to CenterWell Pharmacy using the provided mailing address. Ensure all sections are filled accurately before submission.
Start using our platform today for free and streamline your OTC ordering process!
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Summary Guide to Benefits - Human Resources - University of
Purchasing OTC Products. Individuals can purchase over-the-counter (OTC) products with their health care flexible spending account. Participants must submit
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