Florida Regulations 64B12-10.0065: Duplicate Prescription Form
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The duplicate prescription form referred to in Florida Statutes § 484.012, shall contain a place for the following:
(1) Name of the client.
(2) Name of the prescribing doctor.
(3) The date of the original prescription.
(4) The sphere.
(5) The cylinder power.
(6) The axis.
(7) The prism power.
(8) The reading power.
Rulemaking Authority 484.005, 484.012 FS. Law Implemented 484.005(1), 484.012(2) FS. History-New 12-6-79, Amended 8-30-84, Formerly 21P-13.01, 21P-13.001, 21P-10.0065, 61G13-10.0065, 59U-10.0065, Amended 8-6-97.
(1) Name of the client.
(2) Name of the prescribing doctor.
(3) The date of the original prescription.
(4) The sphere.
(5) The cylinder power.
(6) The axis.
(7) The prism power.
(8) The reading power.
Rulemaking Authority 484.005, 484.012 FS. Law Implemented 484.005(1), 484.012(2) FS. History-New 12-6-79, Amended 8-30-84, Formerly 21P-13.01, 21P-13.001, 21P-10.0065, 61G13-10.0065, 59U-10.0065, Amended 8-6-97.