| 1 | English French  Notes   Complete/Exclude
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| 2 | WINDOW -                        
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| 3 | NEXT PATIENT                    
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| 4 | (fill document continued)                       
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| 5 | (continued on next fill document)                       
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| 6 | Mfr ___________________ Lot# _______________________                    
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| 7 | Tech__________________ RPh _______________________                      
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| 8 | DO NOT MAIL                     
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| 9 |     Days supply:                        
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| 10 |     Last Fill:                  
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| 11 | NO REFILL for this prescription                 
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| 12 | NO REFILLS LEFT for this prescription                   
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| 13 | PHONE IN OR MAIL YOUR REFILL REQUEST                    
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| 14 | Follow the refill instructions provided with your prescription.                 
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| 15 | NO REFILL                       
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| 16 | NO REFILLS LEFT                 
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| 17 |  refills left until                     
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| 18 | HAS YOUR ADDRESS CHANGED?                       
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| 19 | Write address changes in the blanks, sign the form, and return to                       
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| 20 | your pharmacy.                  
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| 21 | [   ] Permanent                     [   ] Temporary until ____/____/____                        
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| 22 | Signature                       
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| 23 | Additional Allergies or Adverse Reactions Exist.                        
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| 24 | Talk to your Physician or Pharmacist.                   
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| 25 | The following prescriptions will be mailed to you on or after the                       
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| 26 | date indicated.                 
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| 27 | Rx#                                          Date                                                               
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| 28 | Use the adhesive label above to mail prescription                       
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| 29 | documents to your pharmacy.                     
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| 30 | Patient's Signature & Date                              
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| 31 | Refills                         
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| 32 | Patient's Signature & Date                              
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| 33 | You have no refillable prescriptions as of                      
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| 34 | Please contact your provider if you need new prescriptions.                     
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| 35 | Please check prescriptions to be refilled, sign the form, then                  
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| 36 | mail or return to your pharmacy.                        
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| 37 | This prescription has caused a DRUG-DRUG INTERACTION.                   
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| 38 |  has caused a DRUG-DRUG INTERACTION with the following prescription(s):                 
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| 39 | This prescription was entered by:                       
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| 40 | This prescription                       
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| 41 | may require                     
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| 42 | THIS PRESCRIPTION HAS CAUSED A DRUG-DRUG INTERACTION                    
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| 43 | The above prescription has a status of PENDING due to a DRUG-DRUG INTERACTION.                  
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| 44 | Please review printouts of all labels for this patient that follow.                     
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| 45 |  has indicated a DRUG ALLERGY:                  
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| 46 | This prescription was entered by                        
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| 47 | This prescription may require reviewing by a pharmacist                 
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| 48 | No terminal type available.                     
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| 49 | No DUZ defined.                 
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| 50 | FileMan access must be @.                       
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| 51 | CONTROL CODES already defined.                  
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| 52 | HP or LexMark:                  
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| 53 | Enter H for HP or L for LexMark                 
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| 54 | You will be copying the CONTROL CODES to device:                        
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| 55 |  are you sure?                  
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| 56 | LASER LABEL                     
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| 57 | LASER LABEL INIT                        
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| 58 | TEN POINT FONT - NO BOLD                        
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| 59 | EIGHT POINT FONT - NO BOLD                      
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| 60 | TWELVE POINT FONT - NO BOLD                     
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| 61 | NINE POINT FONT - NO BOLD                       
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| 62 | START OF TEXT                   
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| 63 | CRITICAL DRUG INTERACTION INITIALIZATION                        
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| 64 | PMI SECTION INITIALIZATION                      
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| 65 | SIX POINT FONT, BOLDED                  
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| 66 | EIGHT POINT FONT, BOLDED                        
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| 67 | NINE POINT FONT, BOLDED                 
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| 68 | TEN POINT FONT, BOLDED                  
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| 69 | 12 POINT FONT BOLDED                    
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| 70 | MAILING LABEL INITIALIZATION                    
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| 71 | ADDRESS CHANGE INITIALIZATION                   
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| 72 | ALLERGY SECTION INITIALIZATION                  
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| 73 | FONT WITH UNDERLINE                     
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| 74 | FONT DISABLE UNDERLINE                  
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| 75 | RETURN MAIL INITIALIZATION                      
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| 76 | SUSPENSE PRINT INITIALIZATION                   
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| 77 | WARNING LABEL INITIALIZATION                    
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| 78 | REFILL NARRATIVE INITIALIZATION                 
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| 79 | COPAY NARRATIVE INITIALIZATION                  
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| 80 | PATIENT INSTRUCTION INITIALIZATION                      
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| 81 | REFILL PRINT INITIALIZATION                     
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| 82 | BOTTLE LABEL HEADER INITIALIZATION                      
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| 83 | BOTTLE LABEL BODY INITIALIZATION                        
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| 84 | BOTTLE LABEL FOOTER INITIALIZATION                      
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| 85 | ROTATE TEXT                     
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| 86 | NORMAL ROTATION                 
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| 87 | PHARMACY FILL DOCUMENT INITIALIZATION                   
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| 88 | PHARMACY FILL DOCUMENT QUANTITY                 
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| 89 | PHARMACY FILL DOCUMENT WARNING                  
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| 90 | ALLERGY WARNING INITIALIZATION                  
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| 91 | SIX POINT FONT - NO BOLD                        
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| 92 | END OF BARCODE TEXT                     
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| 93 | BOTTLE LABEL BARCODE                    
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| 94 | PHARMACY FILL DOCUMENT TRAILER                  
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| 95 | END OF BOTTLE LABEL BARCODE                     
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| 96 | START OF BARCODE TEXT                   
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| 97 | PATIENT FILL INITIALIZATION                     
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| 98 | No CONTROL CODES defined.                       
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| 99 | PSO LM ALLERGY DISPLAY                  
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| 100 | This is a test header for PSO LM ACTION ORDER.                  
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| 101 | This is the second line                 
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| 102 | PSO LM ACTIVE ORDERS                    
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| 103 | PSO LM DETAILED ALLERGY                 
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| 104 | PSO LM ORDER SELECTION                  
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| 105 | This is a test header for PSO LM ORDER SELECTION.                       
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| 106 | OP Medications (                        
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| 107 | Site Parameters must be Defined!                        
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| 108 | >>PHARMACY PATIENT DATA<<                       
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| 109 | Patient Data is Being Edited by Another User!                   
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| 110 | PSO LM PROFILE                  
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| 111 | PSO LM Patient Information                      
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| 112 | PSO LM PENDING ORDER                    
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| 113 | Pending OP Orders (                     
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| 114 | PSO LM COMPLETE ORDER                   
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| 115 | PSO LM BACKDOOR ORDER                   
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| 116 | New OP Order (                  
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| 117 | PSO LM RENEW LIST                       
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| 118 | Site parameter must be defined!                 
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| 119 | PSO REFILL                      
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| 120 | PSO RENEW                       
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| 121 | PSO REPRINT                     
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| 122 | PSO EDIT ORDERS                 
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| 123 | PSO RELEASE                     
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| 124 | PSO PARTIAL                     
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| 125 | PSO CANCEL                      
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| 126 | PSO HOLD                        
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| 127 | PSO UNHOLD                      
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| 128 | PSO LM BACKDOOR COPY                    
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| 129 | PSO VERIFY                      
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| 130 | PSO ACTIVITY LOGS                       
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| 131 | PSO LM DISCONTINUE                      
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| 132 | PSO LM EDIT                     
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| 133 | PSO LM FINISH                   
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| 134 | DUZ Number must be defined !!                   
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| 135 | Outpatient Pharmacy software - Version                  
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| 136 | PSO_V7 INSTALL                  
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| 137 | Outpatient Pharmacy software is being installed.  PLEASE TRY LATER!                     
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| 138 | Site parameters must be specified for at least one site.                        
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| 139 | This is usually done by the package Co-ordinator.                       
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| 140 | Do you want to continue:                        
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| 141 | Enter Y to edit site parameters or N to exit.                   
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| 142 | Enter 'Y' to select Division or 'N' to EXIT                     
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| 143 | A 'DIVISION' must be selected!                  
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| 144 | Select PROFILE PRINTER:                         
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| 145 | OK to assume label alignment is correct                 
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| 146 | Enter Y if labels are aligned, N if they need to be aligned.                    
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| 147 | Printer is busy.                        
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| 148 | Align labels so that a perforation is at the top of the                 
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| 149 | print head and the left side is at column zero.                 
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| 150 | Enter Y if labels are aligned correctly, N if they need to be aligned.                  
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| 151 | Default printer for labels must be entered.                     
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| 152 | Bingo Board Display:                    
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| 153 | Enter 'Y' to select Bingo Board Display or 'N' to EXIT                  
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| 154 | A 'BINGO BOARD DISPLAY' should be selected!                     
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| 155 | A display group must be defined in order to run Bingo Board.                    
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| 156 |  ******* Auto Expire of Prescriptions *******                   
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| 157 | You need to run this job only if expired prescriptions are showing up as active                 
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| 158 | orders on the Orders tab in CPRS. This could be due to the following:                   
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| 159 | 1. The Expire Prescriptions [PSO EXPIRE PRESCRIPTIONS] option was not                   
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| 160 |    queued as a daily task.       *****  AND *****                       
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| 161 | 2. Those patient's prescription(s) were never being accessed/viewed in                  
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| 162 |    Patient Prescription Processing [PSO LM BACKDOOR ORDERS] option.                     
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| 163 | * For sites that have not queued the Expire Prescriptions job on their        *                 
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| 164 | * daily task schedule, you  should do so by selecting the Queue Background    *                 
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| 165 | * Jobs [PSO AUTOQUEUE JOBS] option from the Maintenance (Outpatient Pharmacy) *                 
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| 166 | * [PSO MAINTENANCE] option and in the Edit Option Schedule template make an   *                 
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| 167 | * entry for Expire Prescriptions [PSO EXPIRE PRESCRIPTIONS] option and        *                 
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| 168 | * schedule it to run daily.                                                   *                 
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| 169 | ***** Outpatient installation date was not found, *****                 
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| 170 | ***** therefore this job cannot be run!!!!!       *****                 
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| 171 | Job not queued!                 
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| 172 | Auto expire of Rxs                      
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| 173 | Purge Management Statistics                     
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| 174 |   Ending date:                  
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| 175 | Purge from                      
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| 176 | No data has been purged.                        
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| 177 | Outpatient Pharmacy Management Data Purge                       
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| 178 | Do you want to compile data prior to yesterday                  
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| 179 | Outpatient Pharmacy Daily Compile of Management Data                    
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| 180 | Outpatient Pharmacy Management Data Recompile                   
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| 181 | One Day                 
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| 182 | Range of Days                   
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| 183 | DIV TOTAL                       
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| 184 | GR TOTAL                        
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| 185 | QUARTER                         
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| 186 |  OUTPATIENT PRESCRIPTION COSTS/PATIENT = $                      
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| 187 | QUARTERLY OUTPATIENT PRESCRIPTION COST/PATIENT NOT AVAILABLE                    
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| 188 | PRESCRIPTION COUNTS                     
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| 189 | CAT A^CAT C^OTH^CAT^DAY^DAY^DAY^FLS^METH^RX^EQ FL^REQ^REQ^REQ                   
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| 190 | TYPE OF PRESCRIPTIONS FILLED                    
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| 191 | % OF FEE                        
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| 192 | FL BY VA                        
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| 193 | PRESCRIPTION COSTS                      
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| 194 | GRAND TOTAL:                    
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| 195 | INTRAVENOUS ADMIXTURE                   
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| 196 |       ALL DIVISIONS                     
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| 197 | PIGGYBKS & SYRS                 
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| 198 | PER DATE                        
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| 199 | TOT     AVG CST                 
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| 200 | TOT        TOT CST                      
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| 201 | **Prescription data available to print starts with                      
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| 202 | **There is no prescription data available to print.**                   
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| 203 | Use the Date Range Compile data option to make the data available.                      
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| 204 | **IV data available to print starts with                        
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| 205 | **There is no IV data available to print.**                     
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| 206 | There is no prescription and IV data available to print.                        
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| 207 | Print data for all or a specific division                       
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| 208 | Answer 'A' for all if you want to print all divisions' report.                  
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| 209 | Answer 'S' for specific if you want to print one division's report.                     
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| 210 | *** PLEASE PRINT ON WIDE PAPER, I.E., 132 COLUMNS. ***                  
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| 211 | Beginning    MONTH/YEAR :                       
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| 212 | Data available to print starts with                     
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| 213 |   End of month cannot be in the future                  
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| 214 | There is no prescription data between                   
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| 215 | Use the Date Range Compile option to make the data available.                   
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| 216 | For IV data, use the Intravenous Admixture option.                      
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| 217 | Report not Queued!                      
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| 218 | Outpatient Management Report                    
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| 219 | PRINT MANAGEMENT STATS STARTING:                        
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| 220 |  INVALID ENDING DATE ???                        
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| 221 | **There is no prescription data between                         
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| 222 | MON TOTAL                       
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| 223 | MONTH TOTAL                     
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| 224 | Is this Rx for treatment of Military Sexual Trauma                      
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| 225 | This Renewal has been designated as                     
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| 226 |  being used for treatment of Military                   
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| 227 | Sexual Trauma.                  
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| 228 | Is this Rx for treatment of Vietnam-Era Herbicide                       
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| 229 | (Agent Orange) exposure                 
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| 230 |  being used for treatment of Vietnam-Era                        
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| 231 | Herbicide (Agent Orange) exposure.                      
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| 232 | Is this Rx for treatment of ionizing radiation exposure                 
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| 233 |  being used for treatment of ionizing                   
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| 234 | radiation exposure.                     
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| 235 | Is this Rx for treatment of environmental contaminant exposure during the                       
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| 236 | Persian Gulf War                        
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| 237 |  being used for treatment of                    
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| 238 | Is this Rx related to treatment of Head and/or Neck Cancer                      
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| 239 |  being used for treatment related to                    
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| 240 | Head and/or Neck Cancer.                        
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| 241 |  Please use the 'Reset Copay Status/Cancel Charges' option                      
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| 242 | to make corrections.                    
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| 243 | Charges' option to make corrections.                    
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| 244 | NEXT POSSIBLE REFILL                    
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| 245 | TYPE OF RX                      
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| 246 | DISPENSED DATE                  
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| 247 | LOGIN DATE                      
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| 248 |  CPRS Order #                   
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| 249 | Sent By Provider.                       
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| 250 | CHCS NUMBER                     
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| 251 | EXTERNAL SYSTEM                 
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| 252 | RELEASED DATE/TIME                      
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| 253 | LAST DISPENSED DATE                     
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| 254 | Another New Order for                   
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| 255 | OLD LAST RX#                    
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| 256 | Incomplete Dosaging Data!                       
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| 257 | Cannot jump ahead ..                    
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| 258 |  fill date is greater than possible expiration date of                  
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| 259 |  -Pending Order was discontinued...                     
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| 260 |  has been discontinued...                       
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| 261 | No information available                        
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| 262 | Select New Rx # for                     
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| 263 | DO REFILL                       
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| 264 | ERR FLG                 
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| 265 | Not a new prescription number!!!                        
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| 266 | Rxn:                    
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| 267 | Prescription Rx#                        
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| 268 |  already being processed.                       
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| 269 | Rx Deleted                      
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| 270 | Fatal error in Autonumbering - No Numbers Left!                 
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| 271 | See Application Package Coordinator!                    
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| 272 | PSO LM ACTIVITY LOGS                    
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| 273 | Rx View                         
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| 274 | Select Activity Log by  number                  
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| 275 | 4.  Label       5.  Copay        6.  CMOP Events  7.  All Logs                  
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| 276 | 4.  Labels      5.  Copay        6.  All Logs                   
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| 277 |    Original Fill Released:                      
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| 278 | (Returned to Stock                      
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| 279 |       Finished by:                      
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| 280 | #   Date        Reason         Rx Ref         Initiator Of Activity                     
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| 281 | There's NO Activity to report                   
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| 282 | REFILL                  
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| 283 | Label Log:                      
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| 284 | #   Date        Rx Ref                    Printed By                    
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| 285 | There are NO Labels printed.                    
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| 286 | Copay Activity Log:                     
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| 287 | #   Date        Reason               Rx Ref         Initiator Of Activity                       
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| 288 | There's NO Copay activity to report                     
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| 289 | ANNUAL CAP REACHED^COPAY RESET^IB-INITIATED COPAY^REMOVE COPAY CHARGE^RX EDITED^                        
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| 290 |   Old value=                    
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| 291 |    New value=                   
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| 292 | Refill Log:                     
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| 293 | #  Log Date   Refill Date  Qty               Routing  Lot #       Pharmacist                    
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| 294 | There are NO Refills For this  Prescription                     
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| 295 | Dispensed:                      
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| 296 |  Returned to Stock:                     
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| 297 | Partial Fills:                  
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| 298 | #   Log Date   Date     Qty              Routing    Lot #        Pharmacist                     
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| 299 | There are NO Partials for this Prescription                     
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| 300 |  RETURNED TO STOCK:                     
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| 301 |       Entry By:                         
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| 302 | Hold Reason:                    
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| 303 | ####################    ####################    ####################    
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| 304 | ####################    ####################    ####################    
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| 305 | ####################    ####################    ####################    
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| 306 | ####################    ####################    ####################    
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| 307 | ####################    ####################    ####################    
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