PREAUTHORIZATION FORMS
Download & Print
Actemra (Tocilizumab)
Botox (Onabotulinum Toxin Type A)
Contrave (naltrexone)
Enbrel (etanercept)
Gilenya (fingolimod)
Kevzara (sarilumab)
Nucala (mepolizumab)
Remicade (infilximab)
Rituxan (rituximab)
Stelara (ustekinumab)
Wellbutrin (bupropion)
Xolair (omalizumab)
Adcirca (Tadalafil)
Brenzys (Etanercept)
Cosentyx (secukinumab)
Entyvio (Vedolizumab)
Humira (adalimumab)
Kineret (anakinra)
Olumiant (baricitinib)
Renflexis (infliximab)
Sativex (cannbidiol buccal spray)
Taltz (ixekizumab)
Xeljanz (tofacitinib)
Aubugio (teriflunomide)
Cialis (Levitra, Viagara, Staxyn)
Dupixent (dupilumab)
Erelzi (etanercept)
Inflectra (infliximab)
Lemtrada (alemtuzumab)
Orencia (abatacept)
Repatha (evolocumab)
Saxenda (liraglutide)
Thyrogen (thyrotropin alfa)
Xenical (orlistat)
Benylsta (belimumab)
Cimzia (certolizumab)
Dysport Therapeutic (Abobotulinumtoxin)
Famprya (fampridine)
Jakavi (ruxolitinib)
Mavenclad (cladribine)
Otezla (apremilast)
Revatio (sildenafil)
Simponi (golimumab)
Tremfya (guselkumab)
Xeomin (clostridium botulinum)