Island 'Flu

First Time Users should contact Kevin Noble at the PCT for discussion and training on (01983) 534271.


Bold fields are required.


MULTIPLE PACKS
If you are giving more than one pack to a single patient (e.g. 2 packs of 30mg capsules to a young adult for a 60mg dose), you can tick GP requisition to reveal the quantity box, enter the quantity but make sure you then UNTICK the GP requisition box please.


IMPORTANT
A GP Requisition is when you have provided an anti-viral product TO A GP OR SURGERY for them to provide to house-bound patients - NOT a supply for a named patient.


Patient & Pharmacy Information

Patient Information

We need to ensure that demographic information is available for analysis and to ensure that you receive your payments for providing the service.

This is the NHS Pharmacy Identifier and is a five digit code that you enter on the form when you submit your prescriptions each month. It always starts with the letter 'F'.
For items requested by a GP, this is the patient number from your PMR. For items requested from the 'Flu Line, this is their flu note number.
Treatment Provided

Treatment Provided

Please identify which treatment you have dispensed - this will allow us to monitor stock availability - and who authorised the treatment.

It will also help us monitor the epidemiology if you can identify the co-morbidities, either where indicated on the authorisation or by asking the flu-friend.

Treatment Dispensed





Treatment Authorisation





















Co-morbidities




Verification

Verification Information

Type the numbers you see to the left.

This ensures that a person, not an automated program, is entering this information.

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