Home Feedback Contents Search

Direct Dispensing

 

 

This duplex script form is mailed to the healthcare provider on the same date that the prescription is shipped via UPS to the patient. The front side provides general instructions for use. Specific instructions for individual conditions may be provided on the reverse side by the healthcare practitioner.

Adobe Acrobat Reader Format          

Black and White 

(As Seen Below)

 (Slower Connections) Type: Dial-up Internet

Script Sheet - A (Front)

Script Sheet - B (Back)

Dispense Form

Color 

(Not Shown)

 (Faster Connections) Type: Cable, DSL, ISDN, etc.
Script Sheet - A (Front) Script Sheet - B (Back) Dispense Form

or print through your browser . . .

Reverse Side

For free personalized prescription forms as shown send electronic mail to RPI of Atlanta or call 800.554.1501 or fax 770.952.7492.

 

 

View All Models

[ Home ]

Send mail to stickdoc@intracell.net with questions or comments.
Copyright © 2005 RPI of Atlanta
FED ID 58-1885467  ~  GA/TEN 060 9915 7230  ~  FDA 89LYG
Website Disclaimer               
Last modified: January 18, 2005