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Drug Prior Authorization Request Form (KY MAP82101, revised 6×1/10) Not to be used for, Atypical Antipsychotic Agents, SuboxoneSubutex, or Brand Name PA requests. Please use specific forms. FAX to

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What is not to be used?

Not to be used refers to items or materials that are prohibited from being used.

Who is required to file not to be used?

Any individual or organization who possesses items not to be used must file a report.

How to fill out not to be used?

The not to be used form must be filled out with detailed information about the prohibited items and the justification for why they are not to be used.

What is the purpose of not to be used?

The purpose of not to be used is to ensure compliance with regulations and prevent the use of harmful or prohibited items.

What information must be reported on not to be used?

The report must include a description of the items, the reason for not using them, and any pertinent details about their disposal or storage.

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