Referral Form available here: PDF Form
We welcome referrals from patients as well as all healthcare providers.
To refer a patient or to self-refer for a medication therapy assessment, the referral form must be completed and faxed it to 709-777-7005. Please call us at 709-777-7491 if you wish to self-refer and do not have access to a fax machine. We cannot accept referrals by email. Please do not email the referral form to the clinic.
What happens after a referral for a medication therapy assessment is sent to the clinic?
Once a referral is received, the patient will be contacted to arrange for a one-on-one appointment with one of our highly specialized clinic pharmacists. Patients are encouraged to bring a family member, partner or friend to the visit with them if they wish, especially if this person helps them with their medication administration at home. Patients should also bring all of their medications with them to their appointment. This includes all medications including:
• Medications prescribed by any doctor or nurse practitioner
• Any creams, ointments or patches
• Inhaler or puffer-type medications and any devices used with them
• Over-the-counter or non-prescription items
• All dietary supplements, herbal products, vitamins and homeopathy
Patients should bring the original packaging for each medication as well as any blister packs, pill boxes or dosette devices used to keep medications in as the pharmacist will review all of this to understand how patients are taking their medications and the types of problems they are experiencing.
The initial clinic visit will typically consist of a one-hour visit with the pharmacist. At this visit, the pharmacist will perform a full medication, medical, and adherence assessment with the patient. The patient and pharmacist will discuss how each medication is working, whether there are any issues or concerns that the patient has regarding the medications, and desired goals of therapy.
Following the patient visit, the pharmacist will review this information along with other pertinent patient data (laboratory results, pharmacy data, etc.) to assess for any medication-related issues and develop a patient care plan, which will be shared with the referring healthcare provider. The healthcare provider will be asked to review and fax the care plan back to the clinic, indicating whether each recommendation in the care plan is acceptable, will be modified or not accepted. This is to ensure everyone understands the care plan that will be implemented. The patient will be followed by the clinic pharmacist as necessary to implement the care plan and assess for achieved outcomes.