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Authorization - Pharmacy

Tips for using eForms:

  • Fill out completely and submit it. You won't be able to start the form and save it for later.
  • You can attach documents to support your request. Please have them ready.
  • You'll be able to print a copy for your patient's medical record at the end.

12/2022: Our pharmacy eforms have been given a new look and feel.

For Medicare prior authorization or formulary exception requests