Write & Send a Prescription

Fill this in once, then choose how it goes out: print and sign, fax it to the pharmacy, or grab the pharmacy's number and call it in. Every order is saved to the patient's record.

Pharmacies & practice details →

Patient

Step 1

The medication

Step 2

Drug name *

Strength

Form

Directions (Sig) *

Quantity *

Refills

Dispense as written (do not substitute)

Diagnosis / indication

Note to pharmacist

Prescriber on the script

Step 3

Prescriber

NPI

DEA (controlled only)

Where it goes

Step 4

No pharmacies on file yet. Add one — name, phone and fax is all it takes.

RAFIQ prints and faxes scripts. It does not transmit through Surescripts, so controlled substances need a signed paper script.

Prescription log

0 most recent

No scripts written yet.