Original-design static form
MedsCheck Pharmacists Worksheet
A browser-readable static PDF version of form 4967-47E, rebuilt without Adobe XFA so it can open in Chrome and standard PDF readers.
Compatibility note: the original upload renders an Adobe Reader 8+ warning page in browser PDF viewers. This static version is PDF 1.4, has no XFA package, and has no PDF JavaScript. It preserves the original worksheet structure, labels, section order, and embedded logos from the XFA template, but it is not a live Adobe XFA form.