Prior Authorization Request Forms Standard PA Forms Standard PA Form (All Non-Opioid Drugs) 1 file(s) 109.30 KB Download Acute Opioid Use PA Form (less than 90 days of opioid use) 1 file(s) 123.73 KB Download Chronic Opioid Use PA Form (greater than 90 days of opioid use) 1 file(s) 217.49 KB Download State Forms Arizona MRO 1.1 Form VIEW California DWC Form RFA VIEW Louisiana 1010 form VIEW New York Web Portal for Prior Authorizations VISIT NY MEDICAL PORTAL or NY MEDICAL PORTAL OVERVIEW West Virginia Controlled Substance Form VIEW
