Prior Authorization Forms
Download and print the most commonly requested prior authorization fax forms for commercial and FEP procedures, injectable drugs (office administered and home self-administered), and oral/topical drugs, choosing from the lists below.
You can also request authorization for Blue Shield 65 Plus and Direct Contracting by using the forms below:
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Office Administered Drugs
Home Self-Administered Injectable Drugs
Commercial and FEP Procedures/HCPCS