1.

Click the name or the case ID number go into the case.

2. Answer Questions

Once in the case the questions will appear at the top.

1. Select Edit at the top right.
2. Answer the questions.

3. Submit

When you are done with the questions:

1. Select "Save and Submit"
2. Select "Submit"

Fax Example

To the right is an example of one of our fax requests for information. 

• If a PA is no longer needed or you need to cancel the request you can select the option and fax it back to us.

2. Fax Us Records or Questionnaire

Fax us either the:

• Last office visit or other appropriate documentation.
• Answer the questionnaire (see right for example)

Not all medication will have a questionnaire yet, in which case please fax us the medical records.

Our fax is: 888-286-3058

You Are Done

When we receive your fax we will fax back an acknowledgement of the receipt.