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Tip
titleVideo Tutorial

To see a very short video tutorial on this follow this link.

1. Select Form

There are two ways a request can be created:

  • Drug Specific Form - These forms will ask you a few questions about the drug. Completion of this form makes it more likely your request will be reviewed accurately and quickly. It is highly recommended to complete this form where available.
    • General Form - Can be used for any drug, but does not ask any drug specific questions.

    Forms can be found be selecting the pharmacy network tab. Recent request types will also appear on the front page. There are two main request types:

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    2. Complete Form

    Each form will require some basic information (patient name, DOB, prescriber, pharmacy). 

  • Drug Specific Form - Medical records are not required, but highly recommended to be submitted with the request.
    • General Form - Some type of documentation will be required with the request.

    • Manually by typing information.
    • Adding a screenshot.
    • Uploading excel file (for many requests at once).

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