To the Pharmacist: 

Please reference stamp illustrations: 

1. Dispense medications explicitly circled or checked by the provider. 

2. Treat crossed-out or marked-through entries as voided. 

Provider's direct contact information is on original Rx. 

Handwritten Exceptions│

Azithromycin 250mg Disp 2 (Two) Tabs Only: Take 2 Stat. 

Handwritten Exceptions│

Fluconazole 150mg Disp: 1 (One) Tab. Sig: 1 PO with food. 

We provide prophylaxis for antibiotic associated yeast infections and endocarditis.

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Exceptions│Addendums