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Form F-00345 HMO Designation of Prescriber for Restricted Medication Services - Pharmacy Services Lock-In Program - Wisconsin
What Is Form F-00345?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form F-00345?
A: Form F-00345 is a document used for HMO Designation of Prescriber for Restricted Medication Services in the Pharmacy Services Lock-In Program in Wisconsin.
Q: What is the purpose of Form F-00345?
A: The purpose of Form F-00345 is to designate a prescriber for restricted medication services in the Pharmacy Services Lock-In Program in Wisconsin.
Q: What is the Pharmacy Services Lock-In Program?
A: The Pharmacy Services Lock-In Program is a program in Wisconsin that limits an individual's access to certain medications from multiple prescribers or pharmacies.
Q: Who needs to fill out Form F-00345?
A: HMOs (Health Maintenance Organizations) in Wisconsin need to fill out Form F-00345 to designate a prescriber for restricted medication services in the Pharmacy Services Lock-In Program.
Form Details:
- Released on May 1, 2015;
- The latest edition provided by the Wisconsin Department of Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form F-00345 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
