The Catamaran Fax Order Form is a prescription request form for home delivery medications. Medical practitioners fill out this form on behalf of their patients. The completed form is faxed to Catamaran Home Delivery pharmacy.
Step 1 collects patient details. The prescriber fills in the Cardholder ID, patient name, and date of birth. A current shipping address is required for delivery.
Step 2 covers prescriber information. The prescriber enters their name, fax number, and NPI number. A DEA number is required when ordering controlled substances.
Step 3 lists the drug details. For each medication, the prescriber enters the drug name, strength, quantity, directions for use, and number of refills. Up to three refills can be requested. If a brand-name drug is medically required, the prescriber must write "brand necessary" or "brand medically necessary" on the form.
Step 4 requires the prescriber's signature. An unsigned form is not valid. After signing, fax the completed form to Catamaran Home Delivery. All patient information is handled under HIPAA confidentiality standards.
| Question | Answer |
|---|---|
| Form Name | Cataramaran Fax Order Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | fax form catamaran, form catamaran form, catamaran home intended, catamaran home delivery of texas |
