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Form catamaran form 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Member Information section. Enter the Cardholder ID # and the Cardholder name, ensuring all characters are included.
- Proceed to the Prescriber Information section. Input the NPI #, Prescriber Name, DEA #, and Fax#. Remember that an NPI is required for all prescriptions.
- In the Patient Information section, provide the Date of birth, Patient Name, and contact details. Specify the Ship to address as needed.
- For each medication, indicate the Drug name, Strength, Quantity, and number of medications on this page. Don’t forget to specify any refills if applicable.
- Finally, sign the prescription in the designated area and include today's date. Ensure you fax it from a secure line without a cover sheet.
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