Ohsu mail order pharmacy 2025

1. Click ‘Get Form’ to open the OHSU Mail Order Pharmacy Prescription Refill Request Form in the editor.
2. Begin by entering today’s date at the top of the form. This helps track your request.
3. Fill in your personal information in the 'Patient Name & Address' section, including last name, first name, middle initial, and complete address.
4. Provide your contact details such as email address and phone number. Ensure accuracy for effective communication.
5. In the 'Patient Profile' section, indicate any drug allergies and health conditions by checking the relevant boxes.
6. List your prescription refill requests under 'Prescription Refill Request Information', including prescription numbers and drug names if desired.
7. Select your preferred delivery option for medications from the available choices provided on the form.
8. Complete the payment information section by entering your credit card details, ensuring you include all required fields for processing.
9. Finally, sign and date the form at the bottom to authorize submission before sending it back via fax or mail.

Start using our platform today to streamline your pharmacy refill process effortlessly!