Please have the following forms filled out and returned to us before making an appointment.
(Referral form only needs to be filled out by referral source)
Thank you!
Commercial:
Medicaid:
Please be aware that when insurance changes, most new insurances will require a prior authorization for medications. This means they will accept or not accept the medication being prescribed and/or pay for it. Please give us at least 3-5 days to get a prior authorization done for the medication.
Please let us know at least a week ahead of time before the patient runs out of medication.
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