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Form F-11183 Designation of Alternate Prescriber for Restricted Medication Services - Pharmacy Services Lock-In Program - Wisconsin
What Is Form F-11183?
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-11183?
A: Form F-11183 is the Designation of Alternate Prescriber for Restricted Medication Services - Pharmacy Services Lock-In Program - Wisconsin.
Q: What is the purpose of Form F-11183?
A: The purpose of Form F-11183 is to designate an alternate prescriber for restricted medication services in the Pharmacy Services Lock-In Program in Wisconsin.
Q: What is the Pharmacy Services Lock-In Program in Wisconsin?
A: The Pharmacy Services Lock-In Program is a program in Wisconsin that restricts the use of certain medications.
Q: Why would someone need to designate an alternate prescriber?
A: Someone would need to designate an alternate prescriber if their primary prescriber is unable to provide the medication services they need.
Q: Who should fill out Form F-11183?
A: Form F-11183 should be filled out by the person who is enrolled in the Pharmacy Services Lock-In Program and wishes to designate an alternate prescriber.
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-11183 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
