HWMG

To submit a prior authorization online, please click the button below to use the web form.

PDF forms are available below to submit a prior authorization through fax.

Title
FDA Medwatch Form
 1 file(s)  552 downloads

BCBSAL, BCBSFL, HiLab, HWMG, RxBenefits, sscripts

May 14, 2019

Download

Opioid Informed Consent
 1 file(s)  50 downloads

HWMG

March 11, 2019

Download

Prior Authorization Request Form
 1 file(s)  2037 downloads

HWMG

November 27, 2018

Download