Provider Forms and Documents

Now submit important forms online

We've made it faster and easier for providers like you to submit the forms you use most. Now the Prior Authorization Guideline Request form and the Formulary Change Request may be submitted online. Just click the links below to get started. The New Prescription Fax Form is still available below to print and fax.

Documents to download and print:

Documents to submit online:

Pharmacy Processing Information and Notices

Pharmacy Appeals Guidelines and Forms:

Provider Frequently Asked Questions:

You may have specific concerns or special situations that you have questions about. The most common questions we are asked are listed in our Provider Frequently Asked Questions. Please refer to these before contacting first.dba.

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