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titleVideo Tutorial

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

1. Select Form

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:



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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