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Request Additional Medication

Use the following form to request a medication be added to one of the CORI v4 menus. To modify the dosage list of existing medications, please see your local CORI system administrator or contact CORI support.

Medication Request
Medication:
Medication Type:
Dosages:
(e.g. 1mg, 2mg...)
E–mail* (optional):
*E–mail will be used to contact you if there are any questions and to inform you when the medication has been added.