BCBS of Florida

To submit a prior authorization online, please click the button below to use the web form.

PDF forms are available below to submit a prior authorization through fax.

Title
FDA Medwatch Form
1 1271 downloads 		90degrees, affirmedrx, BCBSAL, BCBSFL, BCBSMN, Credence, HiLab, oreadrx, pcarx, rxsense, verusrx August 31, 2023 Download
General PA Request Form
1 4787 downloads 		BCBSFL November 11, 2021 Download