Prior Authorization
Prior Authorizations/Medication Requests are available for our payors individually, please click the link below for the correct forms.
Please note: ICORE's online pharmacy authorizations resource and generic prior authorization forms are for pharmacy dispensing clients and not intended for use by ICORE's Oncology Benefit Management (OBM) or Provider Administered Drug Program (PADP) clients. If you need to obtain a prior authorization for OBM or PADP, please use the Get an Authorization online tool or refer to the educational materials that were distributed for using the online tools.
