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UPMC Health Plan RELIANT Prior Authorization Form IF THIS IS AN URGENT REQUEST, please call UPMC Health Plan Pharmacy Services. Otherwise, please return completed form to: UPMC HEALTH PLAN PHARMACY

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To fill out the "otherwise please return completed" form, follow these steps:

1. Obtain the form: You can get the form either by downloading it from a website or by obtaining a physical copy from the relevant organization.
2. Read the instructions: Before filling out the form, carefully read the instructions provided. These instructions will guide you on how to complete the form accurately.
3. Provide personal information: Start by entering your personal information, such as your full name, date of birth, address, and contact details. Make sure to provide accurate and up-to-date information.
4. Fill in the required sections: The form may have various sections that you need to complete. Follow the instructions and fill in the necessary details. This could include information about the purpose of the form, any relevant dates, and other specific information required.
5. Review and double-check: Once you have filled out all the required sections, review the form carefully. Check for any missing or incorrect information. Make sure everything is accurately filled out.
6. Sign and date the form: In most cases, you will be required to sign and date the form to certify its accuracy.
7. Submit the completed form: Once you have reviewed and signed the form, you can then submit it as per the instructions provided. This could be by mailing it to a specific address, submitting it online, or delivering it in person.

"Otherwise please return completed" forms are typically needed by organizations that require specific information from individuals. This could include government agencies, educational institutions, employers, or any other entity that needs to gather information for a particular purpose. The reason for requesting the form to be returned if not completed is to ensure that all necessary information is provided for their processes or records.

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To fill out otherwise please return completed, all sections and fields must be completed accurately and any required documentation must be attached.

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The purpose of otherwise please return completed is to ensure that all necessary information is provided and that the form or document is submitted correctly.

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