Abstract: System and method for facilitating a medical order/prescription of a prescription product, including a memory device to store predefined forms for the prescription product corresponding to a plurality of providers. A receiver receives prescription product information for the prescription product, patient intake information for the patient, including provider information for the patient, and a benefits summary related to the patient. A transmitter transmits the benefits verification request. A processor can be configured to generate the benefits verification request for the patient based on the patient intake information, select one of the predefined forms based on at least the patient provider information, populate at least one field of the selected predefined form based on the user intake information, and release the populated predefined form to facilitate a medical order/prescription of the prescription product to the patient.