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GHA Prior Authorization Criteria Form 201610/05/2015
Prior Authorization Form
GHA
Insomnia Agents (APA)
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How to fill out brand medications requiring use

How to fill out brand medications requiring use
01
Read the instructions provided with the medication carefully.
02
Ensure that you have the correct brand medication that has been prescribed to you.
03
Check the dosage and follow the prescribed amount for each dose.
04
If the medication needs to be taken with food or water, make sure to do so.
05
Use the measuring device provided with the medication to accurately measure the dose.
06
Administer the medication as directed by your healthcare professional.
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If any side effects occur, report them to your doctor immediately.
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Do not stop taking the medication without consulting your doctor.
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Store the medication in a cool and dry place, away from direct sunlight.
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Dispose of any unused medication properly, following the recommended guidelines.
Who needs brand medications requiring use?
01
Individuals who have been prescribed specific brand medications by their healthcare providers.
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Patients who have tried generic alternatives and have not achieved the desired results.
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Patients who are participating in clinical trials or specific treatment plans.
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Individuals who have allergies or sensitivities to certain inactive ingredients found in generic medications.
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People who prefer to use brand medications due to personal preferences or previous positive experiences.
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