Across
- 6. DON'T USE THIS TO REQUEST REFILLS
- 7. ALWAYS SELECT THIS FILING ORDER FOR COUPON
- 9. HOW MANY DOLLARS IS THE EXTRA FEE PER RX ADDED BY UNC-SA
- 12. CONTACT PERSON AT UNC-SA
- 13. STUDENT HEALTH INSURANCE
Down
- 1. FYI FLAG
- 2. PRIORITY LEVEL
- 3. DELIVERY PREFERENCE
- 4. INCLUDE UNC-SA PINK BASKET HERE
- 5. CALL BEFORE SENDING IF COPAY HIGHER THAN
- 8. DON'T FORGET TO GET THIS INFO FROM DEMOGRAPHIC SHEET FAX
- 10. BASKET COLOR
- 11. THIS IS WHERE PATIENT PICKS UP