Available in English or Spanish.
This form was developed in an effort to make it
convenient for the pharmacist to comply with
both the letter and the spirit of OBRA-90.
We believe that this 5 1/8" x 8 1/16"
form contains all the information you will
need to counsel your patients,
as well as supply you with much of the
additional information you need for billing,
and filing insurance forms.
