Ready Fill Desk DropAttestation



  1. First Name


  1. Last Name


  1. UID/ZID


  1. Location
    Henderson
    Houston
    Madison
    Raleigh
    Fort Pierce
    Sunrise
    Yuma
    Nashville
    Nashville WFH
    Orlando WFH
    Solon
    Solon WFH


  1. I attest that I have received the Ready Fill desk drop, understand the process and will comply with it's requirement to review all Rx on file with members when the following occurs:
    - HEE Opportunity is flashing and RFM is available
    - Member asked about automatic refills
    - During the refill process

    Refer to - TSRC-PROD-001628 MED D - Auto Refill and Renewal (formerly known as ReadyFill at Mail)
    Yes
    No