PDF forms are available below to submit a prior authorization through fax.
| Title | Categories | Update Date | Download |
|---|---|---|---|
|
FDA Medwatch Form 1 2420 downloads |
90degrees, affirmedrx, BCBSAL, BCBSFL, BCBSMN, Credence, Four Corners Health, HiLab, oreadrx, pcarx, rxsense, scriptwellrx, verusrx | December 31, 2024 | Download |
|
OreadRx Prior Authorization Request Form 1 2078 downloads |
oreadrx, rxsense | May 13, 2022 | Download |