Common use of Electronic Prescribing Clause in Contracts

Electronic Prescribing. I hereby consent to and authorize Certified Dermatologists and its affiliates, including physicians or other prescribers providing treatment to me or the patient named below at a Certified Dermatologists facility, to access or input prescription benefit or medication history for me, or the patient named below, on the Surescripts Network or other electronic prescription services.

Electronic Prescribing. I hereby consent to and authorize Certified Cerﳳfied Dermatologists and its affiliatesaffiliates, including physicians or other prescribers providing treatment to me or the patient paﳳent named below at a Certified Cerﳳfied Dermatologists facility, to access or input prescription benefit prescripﳳon benefit or medication medicaﳳon history for me, or the patient paﳳent named below, on the Surescripts Network or other electronic prescription prescripﳳon services.

Electronic Prescribing. I hereby consent to and authorize Certified Cerﳳfied Dermatologists and its affiliates, including physicians or other prescribers providing treatment to me or the patient paﳳent named below at a Certified Cerﳳfied Dermatologists facility, to access or input prescription prescripﳳon benefit or medication medicaﳳon history for me, or the patient paﳳent named below, on the Surescripts Network or other electronic prescription prescripﳳon services.