{"id":2227,"date":"2016-08-15T15:23:55","date_gmt":"2016-08-15T15:23:55","guid":{"rendered":"https:\/\/www.bates.edu\/health-services\/?page_id=2227"},"modified":"2025-01-06T10:18:12","modified_gmt":"2025-01-06T15:18:12","slug":"health-forms","status":"publish","type":"page","link":"https:\/\/www.bates.edu\/health-services\/health-forms\/","title":{"rendered":"CMMC Pharmacy Forms"},"content":{"rendered":"

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<\/p>\n\n\n\n\n\n\n\n\n
Health Form<\/span><\/center><\/td>\n
Instructions<\/center><\/td>\n<\/tr>\n
CMMC Pharmacy Delivery Request Form<\/a><\/td>\nPrint, Complete, and Sign.<\/u><\/span>If you are interested in having your prescriptions delivered to Bates College where you can pick them up at Post and Print, fill out the following form and send it to the CMMC Pharmacy by fax or mail. If you need help with this, please email healthservices@bates.edu.<\/p>\n

Mail to:<\/strong><\/p>\n

CMMC Pharmacy<\/p>\n

12 High Street<\/p>\n

Lewiston, ME<\/p>\n

04240<\/p>\n

Fax:<\/strong> 207-795-7552<\/td>\n<\/tr>\n

Credit Card Authorization Form<\/a><\/span><\/td>\nPrint, Complete, and Sign.<\/u><\/span>CMMC Pharmacy accepts MasterCard and Visa (including debit cards and\/or health plan benefit \u201cbenny\u201d cards which have the MasterCard or Visa designation) credit cards for the payment of fees incurred at CMMC Pharmacy. Fill out the following form and send it to the CMMC Pharmacy by fax or mail. If you need help with this, please email healthservices@bates.edu.<\/p>\n

Mail to:<\/strong><\/p>\n

CMMC Pharmacy<\/p>\n

12 High Street<\/p>\n

Lewiston, ME<\/p>\n

04240<\/p>\n

Fax:<\/strong> 207-795-7552<\/td>\n<\/tr>\n

CMMC Pharmacy Patient Demographic Form<\/a><\/span><\/td>\nPrint, Complete, and Sign.<\/u><\/span>This information is requested by CMMC Pharmacy so we can provide appropriate pharmacy services to you.<\/p>\n

Fill out the following form and send it to the CMMC Pharmacy by fax or mail. If you need help with this, please email healthservices@bates.edu.<\/p>\n

Mail to:<\/strong><\/p>\n

CMMC Pharmacy<\/p>\n

12 High Street<\/p>\n

Lewiston, ME<\/p>\n

04240<\/p>\n

Fax:<\/strong> 207-795-7552<\/td>\n<\/tr>\n

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Have Questions? Need Help?<\/h3>\n

Please feel free to contact us either by email, healthservices@bates.edu<\/a>, or by calling 207-786-6199.<\/i><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Health Form Instructions CMMC Pharmacy Delivery Request Form Print, Complete, and Sign.If…<\/p>\n","protected":false},"author":870,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_hide_ai_chatbot":false,"_ai_chatbot_style":"","associated_faculty":[],"_Page_Specific_Css":"","_bates_restrict_mod":false,"_table_of_contents_display":false,"_table_of_contents_location":"","_table_of_contents_disableSticky":false,"_is_featured":false,"footnotes":"","_bates_seo_meta_description":"","_bates_seo_block_robots":false,"_bates_seo_sharing_image_id":0,"_bates_seo_sharing_image_twitter_id":0,"_bates_seo_share_title":"","_bates_seo_canonical_overwrite":"","_bates_seo_twitter_template":""},"class_list":["post-2227","page","type-page","status-publish","hentry","with-sidebar"],"_links":{"self":[{"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/pages\/2227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/users\/870"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/comments?post=2227"}],"version-history":[{"count":24,"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/pages\/2227\/revisions"}],"predecessor-version":[{"id":5734,"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/pages\/2227\/revisions\/5734"}],"wp:attachment":[{"href":"https:\/\/www.bates.edu\/health-services\/wp-json\/wp\/v2\/media?parent=2227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}