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    Adobe PDF

    Anemia Evaluation PDF

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    $299.00 $19.95 Add to cart

    Anemia Evaluation Adobe PDF online form – downloadable, printable, reproducible.

    Purchase this evaluation form to perform on patients and download directly to your drive, where you can safely store it and make copies as necessary.

    Form can be filled out online with or without printing, and then emailed directly from the application.

    A PDF reader is required to view this form Adobe offers free Adobe Acrobat for viewing PDFs.

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    Adobe PDF

    BHRT Enrollment Form

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    $449.95 $29.95 Add to cart

    BHRT Enrollment Form

    The BHRT Enrollment Form is a useful form for pharmacies to market to prescribers, because bio-identical hormone replacement therapy is a very lucrative investment.

    After purchasing the form, pharmacies can enter their information in the header.

    The pharmacy saves the form with their information in the header.

    Then, the pharmacy can present the form to prescribers as marketing, advertising, or for entering prescriptions for patients.

    When the doctor receives a patient, then they enter the prescription information into the form.

    Finally, the prescriber can fill out the form electronically on a mobile device or computer or manually by printing out the form.

    Also, the prescriber can sign the form electronically or manually after printing the form.

    The following drugs are available on the form:

    • Biest, and
    • Estradiol, and
    • Progesterone, and
    • Estriol, and
    • Oxytocin, and
    • Hormone-free moisturizer, and
    • Estriol/Hyaluronic Acid, and
    • Scream cream, and
    • Thyroid MR caps, and
    • Levothyroxine, and
    • Liothyronine, and
    • Testosterone.

    The form is available as a Zip file, containing both an interactive Adobe PDF and an image file.

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    Coordinating Prior Authorizations SOP & WIs

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    $995.95 $165.95 Add to cart

    Coordinating Prior Authorizations

    The Coordinating Prior Authorizations collection of documents is a must have for pharmacies.

    It includes the standard operating procedure (SOP) pharmacies follow when handling prior authorizations.

    Additionally, the collection includes all the referenced work instructions (WIs) from the SOP.

    The collection includes the following documents:

    • Coordinating Prior Authorizations SOP, and
    • Retrieving Chart Notes in PASS Work Instruction, and
    • Preparing Prior Authorizations Work Instruction, and
    • Selecting Prior Authorizations In PASS Work Instruction, and
    • Filing Prescriptions In PASS Work Instruction, and
    • Scanning Prior Authorizations In PASS Work Instruction, and
    • Entering Prior Authorization Notes In PASS Work Instruction, and finally
    • The flowchart of the SOP.

    PASS stands for Pharmacy Administration Software System.

    Since it is a non-specific acronym, it can refer to any application used by pharmacies similar to MicroMerchant.

    Therefore, the documents purposely reference this acronym to avoid the need for heavy changes throughout the documents.

    This is the complete standard operating procedure with the referenced work instructions.

    This collection of documents is an ideal companion for every pharmacy to remain compliant with accreditation agencies and governing bodies.

    The product is provided as a compressed zip file.

  • Sale! dermatology compoundingdermatology compounding
    Adobe PDF

    Dermatology Compounding Enrollment Form

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    $595.00 $19.95 Add to cart

    Dermatology Compounding Enrollment Form

    The Dermatology Compounding Enrollment Form is a useful albeit vital document for compounding pharmacies.

    As with all enrollment forms offered by Pharmhandz, this document is an interactive Adobe PDF form that users can fill out online.

    After purchasing the form, pharmacies can enter their information in the header.

    The pharmacy saves the form with their information in the header.

    Then, the pharmacy can present the form to prescribers as marketing, advertising, or for entering prescriptions for patients.

    When the doctor sees a patient, then they enter the prescription information into the form.

    Finally, the prescriber can fill out the form electronically on a mobile device or computer or manually by printing out the form.

    Also, the prescriber can sign the form electronically or manually after printing the form.

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    Drug Monograph – Specialty Drugs Cheat Sheet

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    $99.95 $18.95 Add to cart

    Specialty Drugs Drug Monograph

    The Drug Monograph is a document that acts as a cheat sheet for specialty drugs (also known as a drug monograph).

    Therefore, the drug monograph is a valuable tool for every pharmacy.

    Research has shown that is has proven especially valuable for specialty pharmacy staff.

    It contains valuable information for a number of specialty drugs that are most frequently sold at specialty pharmacies.

    As a result, pharmacy staff can easily reference important information about specialty drugs in one location.

    Sample

    The image below is a sample page from the product:

     

    Description

    This eight page document provides a list of all the major specialty pharmacy drugs in stock at specialty pharmacies.

    The product is available to download as separate image files of the document.

    Reference Tool

    The product is a great reference tool for beginners or new employees at specialty pharmacies.

    From pharmacists, technicians, and inventory, all employees benefit from this resource.

    This monograph is a great tool to keep nearby throughout the day.

    Even seasoned professionals find the drug monograph valuable as a job aid.

    Expectations

    Customers expect staff to be knowledgable and well informed.

    However, with all the information a new employee has to retain, it’s unfair to expect them to remember every detail of the drugs on the shelves.

    Even a veteran  with years of experience will agree that it’s easy to forget some of the most basic information about drugs as new information is constantly being added.

    Details

    With a drug monograph at their desk, employees can quickly reference drug facts from an alphabetical list.

    These include the generic name, the dosage forms, the available strengths, drugs storage requirements, necessary supplies, such as needles or alcohol swabs, and of course the indication.

    The document also provides the monograph of course as well as the place in which to administer the drug.

    This is typically at the prescriber’s office or the patient’s home.

    Savings

    Employees will not remember everything.

    And those employees who do not work with drugs intimately or with customers regularly might not have the drug monograph information at the top of their list of priorities.

    Therefore, having this document handy saves time, money, and frustration.

    Additionally, the document makes sure everybody has access to the same information on the drugs being sold by the specialty pharmacy.

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    Financial Assistance Request Form

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    $195.00 $19.95 Add to cart

    Financial Assistance Request Form

    The Financial Assistance Request Form provides pharmacies with one of the most essential tools for patients.

    With this form, patients can quickly and easily request financial assistance for their prescriptions.

    The form is interactive.

    Pharmacies fill out the header of the form online.

    Afterwards, pharmacies can email, hand out, or offer the form online.

    Once prepared, patients can fill out and submit the form electronically.

    Alternatively, pharmacies can fill out the form on behalf of patients, and then the patient signs the form.

    This form is a great tool to show patients that they have options available to them.

    The document is provided in a zip file format with the PDF and an image file available.

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    Adobe PDF

    FREE Mail Order Worker’s Comp Free Sample Form

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    $185.95 $0.00 Add to cart

     

    Free form, try it.

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    Adobe PDF

    Gastroenterology Enrollment Form

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    $495.99 $29.95 Add to cart

    Gastroenterology Enrollment Form

    The Gastroenterology Enrollment Form for pharmacies to offer prescribers of the therapy.

    This form is a great tool for marketing and advertising the pharmacy to potential prescribers.

    Also, it is valuable to remind existing prescribers that the pharmacy has the medications for those patients.

    Pharmacies enter their information in the header.

    Afterwards, pharmacies can save the form to send copies to prescribers.

    Then, prescribers can fill out the form for each patient.

    Doctors can enter the information manually or electronically.

    At the bottom of the form, there is a signature field for prescribers.

    Once complete, prescribers can submit the form electronically, by fax, or by mail.

    Alternatively, prescribers can scan the form.

    The following drugs are listed on this enrollment form.

    Strengths vary per medication. However, there is an area available to manually enter or electronically input strength, Sig, Qty, & Refills for each listed drug.

    • Humira (Induction, Pen, PFS, Maintenance)
    • Simponi (100mg SmartJect, AutoInject, PFS)
    • Cimzia (200mg, Starter, Lyophilized Vials, Prefilled Syringes)
    • Entyvio (300mg)
    • Remicade (100mg, free entry)
    • Xifaxan (550mg, 200mg)
    • Stelara (Induction) (260mg, 390mg, 520mg)
    • Stelara (Maintenance) (90mg Prefilled)
    • Uceris (9mg)
    • Viberzi (75mg, 100mg)

    The product is offered as a zip file.

    It contains an Adobe PDF and an image file.

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    Growth Hormone Deficiency Enrollment Form

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    $295.95 $25.95 Add to cart

    Growth Hormone Deficiency Enrollment Form

    The Growth Hormone Deficiency Enrollment Form is an essential tool for marketing and advertising of pharmacies to prescribers.

    The pharmacy fills out its information in the header of the form.

    Then, the pharmacy sends the form to prescribers.

    After receiving the form, prescribers fill it out and return it to the pharmacy.

    The form contains Patient Information and Prescriber Information sections.

    Also, it contains the prescription information section.

    Finally, a Signature field is available at the bottom of the form for the prescriber’s signature.

    Additionally, the Signature field area contains a standard pharmacy and HIPAA disclaimer.

    The following drugs are listed on this enrollment form:

    • Genotropin, and
    • Pen – Genotropin, and
    • MiniQuick – Genotropin, and
    • Humatrope, and
    • Norditropin FlexPro, and
    • Nutropin AQ NuSpin, and
    • Omnitrope, and
    • Omnitrope Pen, and
    • Saizen, and
    • Zomacton, and finally
    • Zoma-Jet5

    The form is available as an Adobe PDF file.

    Also, the form is an interactive document.

    Pharmacies can enter the information in the header on their computer. Also, prescribers can enter the patient’s and their information electronically as well.

    Prescribers can send the form electronically or print it out and send it by fax.

    Also, prescribers can scan the form after entering the information manually and send it electronically.

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    Hardship Enrollment Form

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    $229.95 $19.95 Add to cart

    Hardship Form

    The Hardship Enrollment Form is an interactive form for the staff of a pharmacy to send to a patient for a signature.

    The staff fills out the form, leaving the signature field at the bottom blank.

    Afterwards, they send the form to the patient by email, fax, or regular mail.

    Then, the patient signs the form and returns to the staff of the pharmacy, and the process is complete.

    Use the Hardship Enrollment Form to offer patients an opportunity to pay for their medications at a future date.

    This form is a valuable resource for any pharmacy.

    PDF is provided as a zip file also containing an image file of the document.

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    Hemophilia Enrollment Form

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    $395.00 $29.95 Add to cart

    Hemophilia Enrollment Form

    The Hemophilia Enrollment Form is a useful form for pharmacies to market to prescribers, because of its value to prescribers.

    After purchasing the form, pharmacies can enter their information in the header.

    The pharmacy saves the form with their information in the header.

    Then, the pharmacy can present the form to prescribers as marketing, advertising, or for entering prescriptions for patients.

    When the doctor receives a patient, then they enter the prescription information into the form.

    Finally, the prescriber can fill out the form electronically on a mobile device or computer or manually by printing out the form.

    Also, the prescriber can sign the form electronically or manually after printing the form.

    The form is available as a Zip file, containing both an interactive Adobe PDF and an image file.

  • Sale! Hepatitis C Enrollment FormHepatitis C Enrollment Form
    Adobe PDF

    Hepatitis C Enrollment Form

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    $295.00 $25.95 Add to cart

    Hepatitis C Enrollment Form

    The Hepatitis C Enrollment Form is an important document for pharmacies to offer prescribers, because it is a widely used form in pharmacy.

    After purchasing the form, pharmacies can enter their information in the header.

    The pharmacy saves the form with their information in the header.

    Then, the pharmacy can present the form to prescribers as marketing, advertising, or to fill prescriptions.

    Additionally, when the doctor receives a patient, then they enter the prescription information into the form.

    Finally, the prescriber can fill out the form electronically on a mobile device or computer or manually by printing out the form.

    Also, the prescriber can sign the form electronically or manually after printing the form.

    The following drugs are available in this form:

    • Harvoni, and
    • Zepatier, and
    • Viekira Pak, and
    • Viekira XR, and
    • Mavyret, and
    • Epclusa, and
    • Vosevi, and
    • Sovaldi, and
    • Daklinza, and
    • Ribapak, and
    • Moderiba, and
    • Ribavirin, and finally
    • Other

    The form is available as an Adobe PDF file, and it is interactive.

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    HIV Enrollment Form

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    $349.95 $29.95 Add to cart

    HIV Enrollment Form

    The HIV Enrollment Form provides pharmacies with the tools for prescribers to submit prescriptions for HIV on behalf of patients. The form is interactive. Prescribers fill out the form online and submit it electronically. Alternatively, prescribers can also print out the form and mail or fax it to the pharmacy.

    The form contains a header for the pharmacy staff to fill out. Afterwards, the body of the form contains an area for the prescriber to fill out their information, the insurance information, and select from 37 different HIV medications.

    Finally, the subscriber may sign the document electronically, using the mouse as a pen, or by printing it out and signing it manually.

    These forms are great tools for pharmacies to use as advertising and marketing collateral for their businesses.

    The document is provided in a zip file format with the PDF and an image file available.

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    Adobe PDF

    Infertility Enrollment Form

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    $449.95 $28.95 Add to cart

    Infertility Enrollment Form

    The Infertility Enrollment Form is a vital form for pharmacies to market or use as advertisement for prescribers, because pregnancy and the associated therapy for it is not only lucrative but has become a vital and rewarding aspect of pharmacology.

    After purchasing the form, pharmacies can enter their information in the header. Ideally, pharmacies enter the information electronically, so that the form appears professionally.

    The pharmacy saves the form with their information in the header.

    Then, the pharmacy can present the form to prescribers as marketing collateral, advertising material, or for entering prescriptions for patients.

    When the doctor receives a patient, then they enter the prescription information into the form.

    Finally, the prescriber can fill out the form electronically on a mobile device or computer or manually by printing out the form.

    Also, the prescriber can sign the form electronically or manually after printing the form.

    The following drugs are available on the form (as well as others not listed):

    • Ganirelix Acetate, and
    • Cetrolide, and
    • Leuprolide Acetate, and
    • Bravelle, and
    • Menopur, and
    • Follistim, and
    • Doxycycline, and
    • Vivelle Dot, and
    • Baby Aspirin, and
    • Prenatal Vitamin, and
    • Ovidrel, and
    • Progesterone, and
    • Corinne, and
    • Endometrin, and
    • Estradiol, and
    • Methylprednisolone, and
    • Folic Acid, and
    • Novarel, and finally
    • Pregnyl.

    The form is available as a Zip file, containing both an interactive Adobe PDF and an image file.

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    IVIG Enrollment Form

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    $399.95 $29.95 Add to cart

    Intravenous Immune Globulin Enrollment Form

    The IVIG Enrollment Form is an essential marketing and advertising document for every specialty pharmacy. Prescribers can fill out the form online and then submit it electronically. Alternatively, prescribers can print out the IVIG Enrollment form and then fax or mail it to the pharmacy.

    The form provides pharmacies the ability to fill out their essential contact information at the top of the page. Afterwards, prescribers fill out their information, the insurance of the patient, and then the prescription information in the body of the form.

    Prescribers select to sign the form electronically or manually. If signed electronically, the form is submitted to the pharmacy in any of the available methods. If signed manually, the prescriber can fax or mail the form. Also, the prescriber can scan the signed form and submit it electronically.

    This is a great marketing and advertising tool for every pharmacy to have in stock. Prescribers feel more comfortable knowing the pharmacy they do business with has enrollment forms prepared for them.

    The product is available as a zip file containing both an image file and a PDF document.