Return Medication Form
Any request submitted will prompt our team to request call tag and FedEx driver will pick up the package.
Hospice nurse requesting return:
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First Name
Last Name
Patient's name:
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First Name
Last Name
Reason a return is being requested:
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Please Select
Patient has too much medication on hand.
Medication was dc'd by provider.
Patient passed away.
Provider changed the dosage or frequency.
Rx error due to: wrong strength, frequency, dosage form or medication.
Shipping error
If package is being returned due to overstock, when would you like us to resend the package?
Please Select
1 week
2 weeks
3 weeks
4 weeks
Never
How many medications are being returned?
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Please upload a photo of all medications being returned:
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I am an authorized hospice nurse to return medications. I confirmed the return order DOES NOT have any medications that have been opened or used. I understand that if I accidently return an order that has used medication(s), it will be returned to sender for destruction. I herby authorize the request to return medications to Compassionate Care Pharmacy.
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