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If the employee has indicated any medications are being taken, they are required to enter those details.



To add each medication, complete the required fields with an asterisk and click the Add Medication button before you continue.

* Family Member:

* Medication:
  Reason Prescribed:
  Dosage:
  Amount Per Day:
  Refills Per Year:
  Still Prescribed :
 
Name Medication
Select
Jane Smith Insulin
   
 


       
       
     
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